340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CAH521313-02 Ascension Sacred Heart - St. Mary's Hospitals, Inc. - DBA Ascension Sacred Heart Hospital (Terminated)
Print
Main Details
Name
Ascension Sacred Heart - St. Mary's Hospitals, Inc. - DBA Ascension Sacred Heart Hospital
Subdivision Name
Crandon Radiology - Radiology
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521313-02
Medicare Provider Number
521313
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2021
Participating Start Date
4/1/2021
Participating Approval Date
1/22/2021
Last Recertification Date
9/3/2021
Termination Date
Termination Reason
1/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Aspirus, Inc
PAT TINCHER, Vice President-Finance, Regional Markets
(715) 847-2425
Primary Contact
Aspirus, Inc.
Stacy Kolz, 340B Pharmacy Program Supervisor
(715) 610-4236
Addresses
Street Address
400 West Glen St.
Crandon, WI 54520
Billing Address
Ascension Sacred Heart Hospital
401 West Mohawk Dr
Tomahawk, WI 54487
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session