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CAH241367-04 Welia Health (Active)
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Main Details
Name
Welia Health
Subdivision Name
Welia Health - Urgency Services
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241367-04
Medicare Provider Number
241367
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/16/2019
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Welia Health
Randy William Ulseth, CEO
(320) 225-3315
Primary Contact
Welia Health
Joe Dvorak, Director of Pharmacy
(320) 225-3592
Addresses
Street Address
1425 MAIN ST N
PINE CITY, MN 55063-6026
Billing Address
Welia Health
301 Highway 65 S
Mora, MN 55051
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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