340B Drug Pricing Program Database
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CAH521317-10 Ascension Calumet Hospital, Inc. (Active)
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Main Details
Name
Ascension Calumet Hospital, Inc.
Subdivision Name
Hospital Department - ENT
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521317-10
Medicare Provider Number
521317
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2018
Participating Start Date
7/1/2018
Participating Approval Date
5/25/2018
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Ascension Wisconsin
Michael Bergmann, President
(920) 831-8913
Primary Contact
Ascension WI
Cescilly Smith-Jenkins, 340B Program Director – Wisconsin
(414) 522-7533
Addresses
Street Address
618 Memorial Drive
Chilton, WI 53014
Billing Address
Calumet Medical Center, Inc.
614 Memorial Drive
Chilton, WI 53014
Comments
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