340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ALLINA HEALTH MERCY PHARMACY
DSH240115A MERCY HOSPITAL
Print
Covered Entity Details
Entity Name
MERCY HOSPITAL
Subdivision Name
Minnesota Perinatal Physicians
Type
Disproportionate Share Hospital
340B ID
DSH240115A
Entity Address
3960 Coon Rapids Blvd NW
220
Coon Rapids, MN 55433-2589
Medicare Provider Number
240115
Outpatient Facility Provider Number
Participating Start Date
10/1/2019
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
ALLINA HEALTH MERCY PHARMACY
Pharmacy Address
11850 BLACKFOOT ST. NW
STE 190
COON RAPIDS, MN 55433
Pharmacy Comments
Contract Details
Approval Date
10/10/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
1/1/2024
Contract Comments
Contacts
Covered Entity Signing Official
Sara Criger, SVP President-MCY
(763) 236-8205
Contract Pharmacy Representative
allina
Ann Byre, Director of Pharmacy Services
(612) 262-5992
Signed By Date
10/10/2016
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