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ALLINA HEALTH HEART HOSPITAL PHARMACY
CAH241378-01 NEW ULM MEDICAL CENTER
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Covered Entity Details
Entity Name
NEW ULM MEDICAL CENTER
Subdivision Name
NEW ULM MEDICAL CENTER- CLINIC
Type
Critical Access Hospital
340B ID
CAH241378-01
Entity Address
1217 8TH Street N
NEW ULM, MN 56073
Medicare Provider Number
241378
Outpatient Facility Provider Number
Participating Start Date
8/6/2010
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
ALLINA HEALTH HEART HOSPITAL PHARMACY
Pharmacy Address
920 E 28TH ST STE H1254
MINNEAPOLIS, MN 55407
Pharmacy Comments
Contract Details
Approval Date
10/8/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
1/1/2024
Contract Comments
Contacts
Covered Entity Signing Official
Michael Grand, Director of Finance
(507) 217-5019
Contract Pharmacy Representative
allina
Ann Byre, Director of Pharmacy Services
(612) 262-5992
Signed By Date
10/8/2019
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