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DSH520037 MARSHFIELD MEDICAL CENTER (ToBeTerminated)
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Main Details
Name
MARSHFIELD MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH520037
Medicare Provider Number
520037
Additional Details
Current Program Status
ToBeTerminated
Registration Date
10/12/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/17/2023
Last Recertification Date
9/5/2024
Termination Date
Termination Reason
7/1/2025
Change of covered entity type
Contacts
Authorizing Official
MMC
Robert Chaloner, President-Marshfield Medical Center-Marshfield/Neillsville
(715) 387-7855
Primary Contact
Marshfield Clinic Health System
Girish Kaimal, Chief Pharmacy Officer
(623) 296-2075
Addresses
Street Address
611 St Joseph Avenue
MARSHFIELD, WI 54449
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated as DSH starting 7/1/2018; Terminated as DSH 1/1/2019; Reinstated 1/1/2024.
10/16/2023
Initial start date as SCH 10/1/2013, Terminated SCH 1/1/2018, Start date as DSH 7/1/2018
05/21/2018
May 2025
May 2025
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