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Hy-Vee Pharmacy Fulfillment Center #4016
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
Hy-Vee Pharmacy Fulfillment Center #4016
Pharmacy Address
Hy-Vee Inc
4707 Fleur Dr
Des Moines, IA 50321
Pharmacy Comments
Contract Details
Approval Date
10/1/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robin Jean Hoeg, Chief Operating Officer of Hospital and Primary Care Services
(507) 453-3789
Contract Pharmacy Representative
Hy-vee Inc.
Marshall Sanders, 340B Program Manager
(515) 267-6009
Signed By Date
10/1/2019
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