340B Drug Pricing Program Database
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DSH240047BB St. Luke's Hospital of Duluth (Active)
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Main Details
Name
St. Luke's Hospital of Duluth
Subdivision Name
Aspirus St. Luke's Cardiac and Pulmonary Rehab Gym
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH240047BB
Medicare Provider Number
240047
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/3/2020
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
St. Luke's Hospital of Duluth
Michael Boeselager, Vice President Support Services
(218) 249-2459
Primary Contact
Aspirus, Inc.
Stacy Kolz, 340B Pharmacy Program Supervisor
(715) 610-4236
Addresses
Street Address
1015 E. 1st Street
1st Floor
Duluth, MN 55805
Billing Address
St. Luke's Hospital of Duluth
915 E 1st Street
Duluth, MN 55805
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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