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SCH240093-00 MAYO CLINIC HEALTH SYSTEM MANKATO (Active)
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Main Details
Name
MAYO CLINIC HEALTH SYSTEM MANKATO
Subdivision Name
Type
Sole Community Hospital
Rural
No
340B ID
SCH240093-00
Medicare Provider Number
240093
Additional Details
Current Program Status
Active
Registration Date
4/6/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/17/2017
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Mayo Clinic
Travis C. Paul, Regional Chair of Administration SWMN
(608) 392-9716
Primary Contact
Mayo Clinic Health System
Matt Lemin, Program Manager
(507) 293-3853
Addresses
Street Address
1025 MARSH STREET
MANKATO, MN 56001
Billing Address
Mayo Clinic Health System Mankato
1025 Marsh Street
Mankato, MN 56001
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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