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MERCY HOSPITAL PHC
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
MERCY HOSPITAL PHC
Pharmacy Address
4050 COON RAPIDS BLVD NW
COON RAPIDS, MN 55433-2522
Pharmacy Comments
Contract Details
Approval Date
4/3/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
TOBY FREIER, PRESIDENT/CEO
(507) 217-5108
Contract Pharmacy Representative
Jill Strykowski, Director of Pharmacy
(763) 236-4137
Signed By Date
4/3/2017
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