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CAH241333-00 MAYO CLINIC HEALTH SYS - ST. JAMES (Active)
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Main Details
Name
MAYO CLINIC HEALTH SYS - ST. JAMES
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241333-00
Medicare Provider Number
241333
Additional Details
Current Program Status
Active
Registration Date
7/5/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/19/2023
Last Recertification Date
8/15/2024
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
1101 MOULTON & PARSONS DRIVE
ST. JAMES, MN 56081
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/2019, terminated 1/1/2021. Reinstated 10/1/2023.
07/19/2023
April 2025
April 2025
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