Contract Pharmacy Details

STERLING
CAH161371-00 Winneshiek Medical Center

Covered Entity Details

Entity Name

Winneshiek Medical Center

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH161371-00

Entity Address

901 Montgomery St
Decorah, IA 52101

Medicare Provider Number

161371

Participating Start Date

7/1/2014

Last Recertification Date

8/14/2024

Pharmacy Details

Pharmacy Name

STERLING

Pharmacy Address

303 2ND AVE SW
CRESCO, IA 52136-1843

Pharmacy Comments

Contract Details

Approval Date

7/14/2017

Contract Begin Date

10/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

5/13/2021
Ownership change

Contacts

Covered Entity Signing Official

Lynn Luloff, CFO
(563) 387-3109

Contract Pharmacy Representative

David Brooks, PiC
(612) 618-6340

Signed By Date

7/14/2017