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RRC520004-57 MCHS FRANCISCAN HEALTHCARE INC (Active)
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Main Details
Name
MCHS FRANCISCAN HEALTHCARE INC
Subdivision Name
MCHS—Franciscan Healthcare in La Crosse—Radiology
Type
Rural Referral Center
Rural
Yes
340B ID
RRC520004-57
Medicare Provider Number
520004
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/10/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/17/2024
Last Recertification Date
Contacts
Authorizing Official
Mayo Clinic Health System
Tanner Holst, Regional Chair-Administration SWWI
(608) 392-9705
Primary Contact
Mayo Clinic Health System
Matt Lemin, Program Manager
(507) 293-3853
Addresses
Street Address
800 WEST AVE S
La Crosse, WI 54601
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/2021; Terminated 10/1/2022; Reinstated 1/1/2025.
10/10/2024
May 2025
May 2025
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