340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH240115E MERCY HOSPITAL (Terminated)
Print
Main Details
Name
MERCY HOSPITAL
Subdivision Name
Courage Kenney Rehabilitation Institute
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240115E
Medicare Provider Number
240115
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/6/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/12/2016
Last Recertification Date
11/9/2017
Termination Date
Termination Reason
7/1/2018
DSH percentage below statutory minimum
Contacts
Authorizing Official
Allina Health
Phillip J. Krolik, VP, Finance
(651) 241-8827
Primary Contact
Allina Health
Jerry Pietz, VP Finance
(763) 236-8355
Addresses
Street Address
11850 Blackfoot Street NW
Suite 130
Coon Rapids, MN 55433
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session