340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RASMUSSEN VILLAGE PHARMACY INC
CAH521347-00 BALDWIN AREA MEDICAL CENTER INC., d/b/a Western Wisconsin Health
Print
Covered Entity Details
Entity Name
BALDWIN AREA MEDICAL CENTER INC., d/b/a Western Wisconsin Health
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH521347-00
Entity Address
1100 Bergslien St
BALDWIN, WI 54002
Medicare Provider Number
521347
Participating Start Date
1/1/2016
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
RASMUSSEN VILLAGE PHARMACY INC
Pharmacy Address
DBA VILLAGE PHARMACY BALDWIN
840 MAIN ST
BALDWIN, WI 54002
Pharmacy Comments
Contract Details
Approval Date
8/20/2014
Contract Begin Date
10/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2015
Contacts
Covered Entity Signing Official
Brian Lovdahl, CFO
(715) 684-8612
Contract Pharmacy Representative
David Willink, Owner
(715) 684-2674
Signed By Date
8/20/2014
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