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DSH520019E ASCENSION SAINT MARYS HOSPITAL (Terminated)
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Main Details
Name
ASCENSION SAINT MARYS HOSPITAL
Subdivision Name
ASPIRUS RHINELANDER & TOMAHA - Family Practice
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH520019E
Medicare Provider Number
520019
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/17/2023
Participating Start Date
7/1/2023
Participating Approval Date
6/1/2023
Last Recertification Date
Termination Date
Termination Reason
7/1/2023
Other
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
205 S MAIN ST
IOLA, WI 54945-9685
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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