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Hy-Vee Pharmacy Fulfillment Center #4016
CAH241378-00 NEW ULM MEDICAL CENTER
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Covered Entity Details
Entity Name
NEW ULM MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241378-00
Entity Address
1324 5TH NORTH ST
NEW ULM, MN 56073
Medicare Provider Number
241378
Participating Start Date
8/6/2010
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
Hy-Vee Pharmacy Fulfillment Center #4016
Pharmacy Address
Hy-Vee Inc
4707 Fleur Dr
Des Moines, IA 50321
Pharmacy Comments
Contract Details
Approval Date
10/15/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TOBY FREIER, PRESIDENT/CEO
(507) 217-5108
Contract Pharmacy Representative
Hy-Vee
Marshall Sanders, Assisant Vice President, Pharmacy Services
(515) 953-7950
Signed By Date
10/15/2018
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