Covered Entity Details

CAH391309-04 Barnes Kasson County Hospital (Active) - information as of 4/28/2025 1:52:08 AM

Main Details

Name

Barnes Kasson County Hospital

Subdivision Name

Barnes Kasson Hospital RHC IV - HS - Rural Health Clinic

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH391309-04

Medicare Provider Number

391309

Outpatient Facility Provider Number

393450

Additional Details

Current Program Status

Active

Registration Date

1/6/2025

Participating Start Date

4/1/2025

Participating Approval Date

1/10/2025

Last Recertification Date

Contacts

Authorizing Official

Barnes Kasson Hospital
Sara F Adornato, Executive Director
(570) 853-3135 Ext: 224

Primary Contact

Barnes Kasson Hospital
Kelli R Kane, CFO
(570) 853-3135 Ext: 224

Addresses

Street Address

25059 State Rt 11
Hallstead, PA 18822-8831

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
CAH391309-01	Child	CAH	Barnes Kasson County Hospital	Barnes Kasson Family Health Clinic RHC III NM	433 Church Street	New Milford	PA	Active
CAH391309-02	Child	CAH	Barnes Kasson County Hospital	Barnes Kasson Family Health Clinic RHC II SQ	2872 Turmpike Street	Susquehanna	PA	Active
CAH391309-03	Child	CAH	Barnes Kasson County Hospital	Barnes Kasson Family Health Clinic RHC DW	177 Erie Blvd.	Susquehanna	PA	Active
CAH391309-04	Child	CAH	Barnes Kasson County Hospital	Barnes Kasson Hospital RHC IV - HS - Rural Health Clinic	25059 State Rt 11	Hallstead	PA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	4/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		Adornato, Sara F Executive Director Barnes Kasson Hospital 5708533135-224	1/10/2025 8:53 AM
Details	340B ID	Update	New Registration		CAH391309-04	1/10/2025 8:53 AM
Details	Entity Subname	Update	New Registration	Barnes Kasson Hospital RHC IV - HS	Barnes Kasson Hospital RHC IV - HS - Rural Health Clinic	1/10/2025 8:53 AM
Dates	Participating Approval Date	Update	New Registration		1/10/2025 8:53:25 AM	1/10/2025 8:53 AM
Details	State	Update	New Registration	Pending	Approved	1/10/2025 8:53 AM
Dates	Signed By Date	Update	New Registration		1/6/2025 11:15:46 AM	1/10/2025 8:53 AM
Dates	Start Date	Update	New Registration		4/1/2025 12:00:00 AM	1/10/2025 8:53 AM
Addresses	Main Address	Insert	New Registration		25059 State Rt 11 Hallstead, PA 18822-8831	1/6/2025 11:15 AM
Contacts	Authorizing Official	Insert	New Registration		Adornato, Sara F Executive Director Barnes Kasson Hospital 5708533135-224	1/6/2025 11:15 AM
Contacts	Primary Contact	Insert	New Registration		Kane, Kelli R CFO Barnes Kasson Hospital 5708533135-224	1/6/2025 11:15 AM
Details	Assistance Received From Date	Insert	New Registration			1/6/2025 11:15 AM
Details	Assistance Received To Date	Insert	New Registration			1/6/2025 11:15 AM
Details	Last Recertification Date	Insert	New Registration			1/6/2025 11:15 AM
Details	Grant Number	Insert	New Registration			1/6/2025 11:15 AM
Details	340B ID	Insert	New Registration			1/6/2025 11:15 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/6/2025 11:15 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/6/2025 11:15 AM
Details	Medicare Provider Number	Insert	New Registration		391309	1/6/2025 11:15 AM
Details	Entity Name	Insert	New Registration		Barnes Kasson County Hospital	1/6/2025 11:15 AM
Details	NOFO Number	Insert	New Registration			1/6/2025 11:15 AM
Details	Program Code	Insert	New Registration		CAH	1/6/2025 11:15 AM
Details	Entity Subname	Insert	New Registration		Barnes Kasson Hospital RHC IV - HS	1/6/2025 11:15 AM
Dates	Participating Approval Date	Insert	New Registration			1/6/2025 11:15 AM
Details	State	Insert	New Registration		Pending	1/6/2025 11:15 AM
Dates	Registration Date	Insert	New Registration		1/6/2025 11:15:44 AM	1/6/2025 11:15 AM
Dates	Signed By Date	Insert	New Registration			1/6/2025 11:15 AM
Dates	Start Date	Insert	New Registration			1/6/2025 11:15 AM
Terminations	Termination Comments	Insert	New Registration			1/6/2025 11:15 AM
Terminations	Termination Date	Insert	New Registration			1/6/2025 11:15 AM
Terminations	Termination Effective Date	Insert	New Registration			1/6/2025 11:15 AM
Terminations	Termination Reason	Insert	New Registration			1/6/2025 11:15 AM