Contract Pharmacy Details

STERLING LONG TERM CARE PHARMACY #30
DSH240006 OLMSTED MEDICAL CENTER

Covered Entity Details

Entity Name

OLMSTED MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH240006

Entity Address

1650 4TH STREET SE
ROCHESTER, MN 55904

Medicare Provider Number

240006

Participating Start Date

7/1/2010

Last Recertification Date

8/16/2024

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

7/13/2021

Contract Begin Date

10/1/2021

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2023
Pharmacy closed

Contacts

Covered Entity Signing Official

Kevin Higgins, Chief Financial Officer
(507) 529-6619

Contract Pharmacy Representative

Sterling Drug
Matt Sneller, Senior Consultant
(612) 360-3584

Signed By Date

7/13/2021

340B Drug Pricing Program Database