Covered Entity Details

CAH391309-03 Barnes Kasson County Hospital (Active) - information as of 5/27/2025 2:43:17 PM

Main Details

Name

Barnes Kasson County Hospital

Subdivision Name

Barnes Kasson Family Health Clinic RHC DW

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH391309-03

Medicare Provider Number

391309

Outpatient Facility Provider Number

393407

Additional Details

Current Program Status

Active

Registration Date

1/6/2014

Participating Start Date

4/1/2014

Participating Approval Date

1/9/2014

Last Recertification Date

8/22/2024

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

177 Erie Blvd.
Suite 3
Susquehanna, PA 18847

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	Last Recertification Date	Update	Recertification	8/22/2023 4:10:35 PM	8/22/2024 9:22:13 AM	8/22/2024 9:22 AM
Contacts	Primary Contact	Update	Recertification	Adornato, Sara F Executive Director Barnes Kasson Hospital 5708533135-224	Kane, Kelli R CFO Barnes Kasson Hospital 5708533135-224	8/22/2023 4:10 PM
Details	Last Recertification Date	Update	Recertification	8/24/2022 10:01:01 AM	8/22/2023 4:10:35 PM	8/22/2023 4:10 PM
Contacts	Authorizing Official	Update	Change Request	Passetti, Dave Administrator Barnes Kasson Hospital 5708533135-487	Adornato, Sara F Executive Director Barnes Kasson Hospital 5708533135-224	4/14/2023 6:40 AM
Contacts	Primary Contact	Update	Change Request	Adornato, Sara F Executive Director Barnes Kasson Hospital 5708533135	Adornato, Sara F Executive Director Barnes Kasson Hospital 5708533135-224	4/13/2023 3:55 PM
Details	Last Recertification Date	Update	Recertification	9/13/2021 7:53:20 AM	8/24/2022 10:01:01 AM	8/24/2022 10:01 AM
Addresses	Main Address	Update	Recertification	401 Broad Avenue Susquehanna, PA 18847	177 Erie Blvd. Suite 3 Susquehanna, PA 18847	9/13/2021 7:53 AM
Details	Last Recertification Date	Update	Recertification	9/8/2020 5:01:46 PM	9/13/2021 7:53:20 AM	9/13/2021 7:53 AM
Details	Last Recertification Date	Update	Recertification	8/29/2019 3:56:33 PM	9/8/2020 5:01:46 PM	9/8/2020 5:01 PM
Details	Last Recertification Date	Update	Recertification	8/21/2018 4:04:20 PM	8/29/2019 3:56:33 PM	8/29/2019 3:56 PM
Details	Last Recertification Date	Update	Recertification	12/4/2017 2:28:21 PM	8/21/2018 4:04:20 PM	8/21/2018 4:04 PM
Contacts	Primary Contact	Update	Recertification	Passetti, Dave Administrator Barnes Kasson Hospital 5708533135-487	Adornato, Sara F Executive Director Barnes Kasson Hospital 5708533135	12/4/2017 2:28 PM
Details	Last Recertification Date	Update	Recertification	8/26/2016 12:00:00 AM	12/4/2017 2:28:21 PM	12/4/2017 2:28 PM
Contacts	Authorizing Official	Update		Passetti, Dave Administrator 5708533135-487	Passetti, Dave Administrator Barnes Kasson Hospital 5708533135-487	10/11/2017 12:12 PM
Contacts	Primary Contact	Update		Passetti, Dave Administrator 5708533135-487	Passetti, Dave Administrator Barnes Kasson Hospital 5708533135-487	10/11/2017 12:12 PM
Contacts	Authorizing Official	Insert			Passetti, Dave Administrator 5708533135-487	6/13/2017 2:17 PM
Contacts	Primary Contact	Insert			Passetti, Dave Administrator 5708533135-487	6/13/2017 2:17 PM
Addresses	Main Address	Insert			401 Broad Avenue Susquehanna, PA 18847	8/26/2016 2:24 PM
Contacts	Signed By	Insert			Iveson Jr., William Clinical Operations Officer 5708533136-292	8/26/2016 2:24 PM
Details	Last Recertification Date	Update		8/5/2015 12:00:00 AM	8/26/2016 12:00:00 AM	8/26/2016 2:24 PM
Details	Last Recertification Date	Update		8/11/2014 12:00:00 AM	8/5/2015 12:00:00 AM	8/5/2015 8:51 AM
Details	Last Recertification Date	Update			8/11/2014 12:00:00 AM	8/11/2014 11:53 AM
Dates	Participating Approval Date	Update			1/9/2014 12:00:00 AM	1/9/2014 2:45 PM
Details	State	Update		Pending	Active	1/9/2014 2:45 PM
Dates	Start Date	Update			4/1/2014 12:00:00 AM	1/9/2014 2:45 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG	CAH391309-03	1/8/2014 12:12 PM
Details	Last Recertification Date	Insert				1/6/2014 2:08 PM
Details	Grant Number	Insert				1/6/2014 2:08 PM
Details	340B ID	Insert			OUTPATIENT_ONLINE_REG	1/6/2014 2:08 PM
Details	Is Authorizing Official EHB Data	Insert				1/6/2014 2:08 PM
Dates	Last Date That 340B Drugs Purchased	Insert				1/6/2014 2:08 PM
Details	Medicare Provider Number	Insert			391309	1/6/2014 2:08 PM
Details	Entity Name	Insert			Barnes Kasson County Hospital	1/6/2014 2:08 PM
Details	Program Code	Insert			CAH	1/6/2014 2:08 PM
Details	Entity Subname	Insert			Barnes Kasson Family Health Clinic RHC DW	1/6/2014 2:08 PM
Dates	Participating Approval Date	Insert				1/6/2014 2:08 PM
Details	State	Insert			Pending	1/6/2014 2:08 PM
Dates	Registration Date	Insert			1/6/2014 12:00:00 AM	1/6/2014 2:08 PM
Dates	Signed By Date	Insert			1/6/2014 12:00:00 AM	1/6/2014 2:08 PM
Dates	Start Date	Insert				1/6/2014 2:08 PM
Terminations	Termination Comments	Insert				1/6/2014 2:08 PM
Terminations	Termination Date	Insert				1/6/2014 2:08 PM
Terminations	Termination Effective Date	Insert				1/6/2014 2:08 PM
Terminations	Termination Reason	Insert				1/6/2014 2:08 PM