Skip Navigation
U.S. Department of Health and Human Services
HRSA
OPA
Toggle navigation
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports/Files
Login
Help
DSH240004AP HENNEPIN HEALTHCARE SYSTEM, INC. - HENNEPIN COUNTY MEDICAL CENTER (Active)
Main Details
Name
HENNEPIN HEALTHCARE SYSTEM, INC. - HENNEPIN COUNTY MEDICAL CENTER
Subdivision Name
GOLDEN VALLEY CLINIC - HCMC - HCMC Golden Valley Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH240004AP
Medicare Provider Number
240004
Outpatient Facility Provider Number
Contacts
Authorizing Official
Hennepin Healthcare System
Wendy Stulac-Motzel, Chief Ambulatory Population Health Officer
(612) 873-6123
Primary Contact
Hennepin Healthcare Systems, Inc. - HCMC
Heather Anderson, Pharmacy Revenue Manager
(612) 873-3225
Additional Details
Current Program Status
Active
Registration Date
10/12/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/24/2017
Last Recertification Date
8/30/2023
Addresses
Street Address
5653 DULUTH STREET
GOLDEN VALLEY, MN 55422
Billing Address
Hennepin Healthcare System, Inc. - Hennepin County Medical Center
701 Park Ave. South
Minneapolis, MN 55415
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
Filter by Comment
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2024
May 2024
week
S
M
T
W
T
F
S
18
28
29
30
1
2
3
4
19
5
6
7
8
9
10
11
20
12
13
14
15
16
17
18
21
19
20
21
22
23
24
25
22
26
27
28
29
30
31
1
23
2
3
4
5
6
7
8
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 close in
60
seconds.
Click OK to continue your session.