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DSH240022D SANFORD WORTHINGTON MEDICAL CENTER (Active)
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Main Details
Name
SANFORD WORTHINGTON MEDICAL CENTER
Subdivision Name
Sanford Worthington Acute Care - Acute Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH240022D
Medicare Provider Number
240022
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/12/2018
Participating Start Date
4/1/2018
Participating Approval Date
2/13/2018
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Sanford Health
Eric Lucas Vanden Hull, Vice President of Finance - Sioux Falls HSD
(712) 261-5275
Primary Contact
Sanford USD Medical Center
Alyssa O Howard, Director of Pharmacy
(605) 695-1697
Addresses
Street Address
1680 Diagonal Road
Worthington, MN 56187
Billing Address
Sanford Worthington Medical Center
1018 6th Avenue
Worthington, MN 56187-0097
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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