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CAH241361-00 MAYO CLINIC HEALTH SYS - NEW PRAGUE (Active)
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Main Details
Name
MAYO CLINIC HEALTH SYS - NEW PRAGUE
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH241361-00
Medicare Provider Number
241361
Additional Details
Current Program Status
Active
Registration Date
4/9/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/15/2019
Last Recertification Date
8/14/2024
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
301 SECOND STREET NE
NEW PRAGUE, MN 56071-1799
Billing Address
MAYO CLINIC HEALTH SYSTEM-NEW PRAGUE
301 SECOND ST. NE
NEW PRAGUE, MN 56071
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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