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STERLING LONG TERM CARE PHARMACY #30
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
STERLING LONG TERM CARE PHARMACY #30
Pharmacy Address
120 W JESSIE ST
PO BOX 370
RUSHFORD, MN 55971-8837
Pharmacy Comments
Contract Details
Approval Date
1/12/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/7/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Robin Jean Hoeg, Chief Operating Officer of Hospital and Primary Care Services
(507) 453-3789
Contract Pharmacy Representative
Sterling Drug
Matt Sneller, Senior Consultant
(612) 360-3584
Signed By Date
1/12/2021
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