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SEIP DRUG #11
CAH241354-00 Astera Health
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Covered Entity Details
Entity Name
Astera Health
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241354-00
Entity Address
421 11th Street NW
Wadena, MN 56482
Medicare Provider Number
241354
Participating Start Date
1/1/2012
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
SEIP DRUG #11
Pharmacy Address
316 MN HIGHWAY 78 N STE 100
OTTERTAIL, MN 56571
Pharmacy Comments
Contract Details
Approval Date
1/2/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/1/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joel Beiswenger, CEO
(218) 631-7489
Contract Pharmacy Representative
Nate Seip, Owner
(218) 640-2722
Signed By Date
1/2/2015
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