340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ST. CROIX FALLS PHARMACY
CAH521337-07 ST. CROIX REGIONAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
ST. CROIX REGIONAL MEDICAL CENTER
Subdivision Name
Webster Health Center
Type
Critical Access Hospital
340B ID
CAH521337-07
Entity Address
26425 Lakeland Avenue South
Webster, WI 54893
Medicare Provider Number
521337
Outpatient Facility Provider Number
528556
Participating Start Date
4/1/2014
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
ST. CROIX FALLS PHARMACY
Pharmacy Address
216 S ADAMS ST
SAINT CROIX FALLS, WI 54024-9449
Pharmacy Comments
Contract Details
Approval Date
10/3/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
John Tremble, CFO
(715) 483-0317
Contract Pharmacy Representative
St. Croix Health
Anita Lundquist, Director of Pharmacy
(715) 483-0236
Signed By Date
10/3/2014
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