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ALLINA HEALTH RITCHIE PHARMACY
CAH241378-00 NEW ULM MEDICAL CENTER
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Covered Entity Details
Entity Name
NEW ULM MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241378-00
Entity Address
1324 5TH NORTH ST
NEW ULM, MN 56073
Medicare Provider Number
241378
Participating Start Date
8/6/2010
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
ALLINA HEALTH RITCHIE PHARMACY
Pharmacy Address
280 NORTH SMITH AVE
SUITE 120
ST PAUL, MN 55102
Pharmacy Comments
Contract Details
Approval Date
11/20/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/2/2016
Pharmacy closed
Contacts
Covered Entity Signing Official
TOBY FREIER, PRESIDENT/CEO
(507) 217-5108
Contract Pharmacy Representative
John P. Bien, CFO
(651) 241-8827
Signed By Date
10/10/2012
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