340B Drug Pricing Program Database
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DSH240115C MERCY HOSPITAL (Active)
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Main Details
Name
MERCY HOSPITAL
Subdivision Name
Allina Health Cancer Institute - Coon Rapids
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240115C
Medicare Provider Number
240115
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
9/4/2019
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Allina Health
Tony M Collins-Kwong, Director, Strategic Sourcing and Services, Pharmacy Services
(612) 262-4785
Primary Contact
Allina Health
Jeremy Enger, 340B Program Manager
(612) 760-7836
Addresses
Street Address
11850 Blackfoot Street NW
300
Coon Rapids, MN 55433-2522
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2016, terminated 7/1/2018. Reinstated 10/1/2019.
07/31/2019
April 2025
April 2025
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