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STOXEN PHARMACY
SCH520019-00 ASPIRUS RHINELANDER HOSPITAL
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Covered Entity Details
Entity Name
ASPIRUS RHINELANDER HOSPITAL
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH520019-00
Entity Address
2251 NORTH SHORE DRIVE
STE 100
RHINELANDER, WI 54501
Medicare Provider Number
520019
Participating Start Date
10/1/2024
Last Recertification Date
Entity Termination Date
4/1/2025
Pharmacy Details
Pharmacy Name
STOXEN PHARMACY
Pharmacy Address
2251 NORTHSHORE DRIVE
RHINELANDER, WI 54501
Pharmacy Comments
Contract Details
Approval Date
4/26/2012
Contract Begin Date
5/1/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/30/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Monica Hilt, Regional VP And Hospital President
(920) 831-8913
Contract Pharmacy Representative
Corliss Stoxen, Owner
(715) 361-4770
Signed By Date
4/30/2012
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