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CAH241328-05 Sanford Bagley Medical Center (Active)
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Main Details
Name
Sanford Bagley Medical Center
Subdivision Name
SANFORD BAGLEY CLINIC / Family Medicine
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241328-05
Medicare Provider Number
241328
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/12/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/3/2016
Last Recertification Date
8/18/2024
Contacts
Authorizing Official
Sanford Health of Northern Minnesota
Lisa Sue Miller, Chief Financial Officer
(218) 333-5523
Primary Contact
Sanford Health of Northern Minnesota
Matthew Aaron Webb, Director of Pharmacy
(218) 333-6339
Addresses
Street Address
1656 CENTRAL W ST
BAGLEY, MN 56621-4357
Billing Address
Sanford Bagley Medical Center
203 4TH ST. NW
BAGLEY, MN 56621
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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