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CAH241345-00 MAYO CLINIC HEALTH SYSTEM - WASECA (Active)
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Main Details
Name
MAYO CLINIC HEALTH SYSTEM - WASECA
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241345-00
Medicare Provider Number
241345
Additional Details
Current Program Status
Active
Registration Date
7/5/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/10/2023
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Mayo Clinic
Travis C. Paul, Regional Chair of Administration SWMN
(608) 392-9716
Primary Contact
Mayo Clinic Health System
Matt Lemin, Program Manager
(507) 293-3853
Addresses
Street Address
501 N. STATE STREET
WASECA, MN 56093
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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