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ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS
RRC520030-00 ASPIRUS WAUSAU HOSPITAL
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Covered Entity Details
Entity Name
ASPIRUS WAUSAU HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC520030-00
Entity Address
333 PINE RIDGE BOULEVARD
WAUSAU, WI 54401
Medicare Provider Number
520030
Participating Start Date
12/21/2022
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
ASPIRUS RHINELANDER & TOMAHAWK HOSPITALS
Pharmacy Address
DBA: ASPIRUS PHARMACY - WESTWOOD WAUSAU
1901 WESTWOOD CENTER BLVD
WAUSAU, WI 54401
Pharmacy Comments
Contract Details
Approval Date
1/3/2023
Contract Begin Date
1/11/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
PAT TINCHER, Vice President-Finance, Regional Markets
(715) 847-2425
Contract Pharmacy Representative
Aspirus
Tyler Hack, Director of Finance
(715) 748-8144
Signed By Date
1/3/2023
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