340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ALLINA HEALTH PIPER BUILDING PHARMACY
DSH240038H United Hospital
Print
Covered Entity Details
Entity Name
United Hospital
Subdivision Name
Apple Valley Medical Imaging
Type
Disproportionate Share Hospital
340B ID
DSH240038H
Entity Address
14655 Galaxie Avenue
Apple Valley, MN 55124
Medicare Provider Number
240038
Outpatient Facility Provider Number
Participating Start Date
10/1/2013
Last Recertification Date
9/4/2020
Entity Termination Date
10/1/2021
Pharmacy Details
Pharmacy Name
ALLINA HEALTH PIPER BUILDING PHARMACY
Pharmacy Address
913 E 26TH ST
1ST FLOOR PIPER BUILDING
MINNEAPOLIS, MN 55404
Pharmacy Comments
Contract Details
Approval Date
4/14/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Phillip J. Krolik, VP, Finance
(651) 241-8827
Contract Pharmacy Representative
Allina Health
Tim J Gallagher, Director, Retail and Specialty Pharmacy
(612) 262-6654
Signed By Date
4/14/2021
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session