340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ESSENTIA HEALTH LAKEWALK PHARMACY
CAH241340-00 NORTHERN PINES MEDICAL CENTER
Print
Covered Entity Details
Entity Name
NORTHERN PINES MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH241340-00
Entity Address
5211 HIGHWAY 110
AURORA, MN 55705
Medicare Provider Number
241340
Participating Start Date
10/1/2012
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ESSENTIA HEALTH LAKEWALK PHARMACY
Pharmacy Address
1502 LONDON RD STE 101
DULUTH, MN 55812-1787
Pharmacy Comments
Contract Details
Approval Date
1/20/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/15/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Laura Ackman, President
(218) 229-2211 Ext: 4222
Contract Pharmacy Representative
Essentia Health
Tim Cernohous, Director of Ambulatory Pharmacy
(218) 786-8516
Signed By Date
1/20/2017
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session