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LEWIS DRUG DISTRIBUTION CENTER
CAH241332-00 WINDOM AREA HOSPITAL
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Covered Entity Details
Entity Name
WINDOM AREA HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241332-00
Entity Address
2150 HOSPITAL DRIVE
WINDOM, MN 56101
Medicare Provider Number
241332
Participating Start Date
9/28/2010
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
LEWIS DRUG DISTRIBUTION CENTER
Pharmacy Address
700 E 54TH ST N
SIOUX FALLS, SD 57104
Pharmacy Comments
Contract Details
Approval Date
10/25/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karrin Witte, CNO
(507) 831-2400 Ext: 0665
Contract Pharmacy Representative
Lewis Drug
Scott Cross, EVP
(605) 367-2800
Signed By Date
10/25/2016
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