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ALLINA HEALTH PIPER BUILDING PHARMACY
DSH240057 ABBOTT NORTHWESTERN HOSPITAL
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Covered Entity Details
Entity Name
ABBOTT NORTHWESTERN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH240057
Entity Address
800 EAST 28TH STREET
MINNEAPOLIS, MN 55407
Medicare Provider Number
240057
Participating Start Date
10/1/2015
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
ALLINA HEALTH PIPER BUILDING PHARMACY
Pharmacy Address
913 E 26TH ST
1ST FLOOR PIPER BUILDING
MINNEAPOLIS, MN 55404
Pharmacy Comments
Contract Details
Approval Date
10/2/2015
Contract Begin Date
1/1/2016
Carve-In Effective Date
1/1/2024
Contract Comments
Contacts
Covered Entity Signing Official
Brian Weinreis, Chief Financial Officer
(612) 863-1920
Contract Pharmacy Representative
allina
Ann Byre, Director of Pharmacy Services
(612) 262-5992
Signed By Date
10/2/2015
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