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ALLINA HEALTH COTTAGE GROVE PHARMACY
CAH241378-03 NEW ULM MEDICAL CENTER
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Covered Entity Details
Entity Name
NEW ULM MEDICAL CENTER
Subdivision Name
Allina Health Cancer Institute - New Ulm
Type
Critical Access Hospital
340B ID
CAH241378-03
Entity Address
1324 5th St N
G110A
New Ulm, MN 56073-1514
Medicare Provider Number
241378
Outpatient Facility Provider Number
Participating Start Date
1/1/2022
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
ALLINA HEALTH COTTAGE GROVE PHARMACY
Pharmacy Address
8611 W POINT DOUGLAS RD S
COTTAGE GROVE, MN 55016-4005
Pharmacy Comments
Contract Details
Approval Date
3/27/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
4/1/2024
Contract Comments
Contacts
Covered Entity Signing Official
Tony M Collins-Kwong, Director, Strategic Sourcing and Services, Pharmacy Services
(612) 262-4785
Contract Pharmacy Representative
Allina Health
Tim J Gallagher, Director, Retail and Specialty Pharmacy
(612) 262-6654
Signed By Date
3/27/2024
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