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MINISTRY HOME CARE SERVICES, LLC
CAH521317-00 Ascension Calumet Hospital, Inc.
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Covered Entity Details
Entity Name
Ascension Calumet Hospital, Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH521317-00
Entity Address
614 MEMORIAL DRIVE
CHILTON, WI 53014
Medicare Provider Number
521317
Participating Start Date
1/1/2011
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
MINISTRY HOME CARE SERVICES, LLC
Pharmacy Address
ASCENSION AT HOME
10050 S 27TH ST STE 100
OAK CREEK, WI 53154-5520
Pharmacy Comments
Contract Details
Approval Date
4/14/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Vanessa Freitag, Vice President, Pharmacy
(715) 897-1183
Contract Pharmacy Representative
COMPASSUS
KRISTEN FANO-SCHULTZE, VICE PRESIDENT OF HOME INFUSION
(803) 391-0674
Signed By Date
4/14/2023
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