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WINONA HEALTH SERVICES CLINIC PHARMACY
SCH240044-00 WINONA HEALTH SERVICES
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Covered Entity Details
Entity Name
WINONA HEALTH SERVICES
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH240044-00
Entity Address
855 MANKATO AVE
WINONA, MN 55987-0600
Medicare Provider Number
240044
Participating Start Date
4/1/2019
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
WINONA HEALTH SERVICES CLINIC PHARMACY
Pharmacy Address
WINONA HEALTH SERVICES
859 MANKATO AVE
WINONA, MN 55987
Pharmacy Comments
Contract Details
Approval Date
7/1/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2020
Agreement registered in error
Contacts
Covered Entity Signing Official
Robin Jean Hoeg, Chief Operating Officer of Hospital and Primary Care Services
(507) 453-3789
Contract Pharmacy Representative
Winona Health Services Clinic Pharmacy
Terry Full, Pharmacist in Charge
(507) 474-3315
Signed By Date
7/1/2019
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