340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MARSHFIELD CLINIC PHARMACY
CAH521328-01 MARSHFIELD MEDICAL CENTER LADYSMITH
Print
Covered Entity Details
Entity Name
MARSHFIELD MEDICAL CENTER LADYSMITH
Subdivision Name
MMC-Ladysmith - Cornell Clinic
Type
Critical Access Hospital
340B ID
CAH521328-01
Entity Address
600 Woodside Drive
Cornell, WI 54732
Medicare Provider Number
521328
Outpatient Facility Provider Number
Participating Start Date
4/1/2022
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
MARSHFIELD CLINIC PHARMACY
Pharmacy Address
1200 PORT ARTHUR RD STE 100
LADYSMITH, WI 54848
Pharmacy Comments
Contract Details
Approval Date
4/13/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jeffrey Euclide, Chief Administrative Officer
(715) 532-6651 Ext: 41107
Contract Pharmacy Representative
MMC
James Rubin, 340B Service Manager
(715) 532-2324
Signed By Date
4/13/2022
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