Covered Entity Details

CAH171346-02 Hospital District No 6 of Harper Co, KS (Active) - information as of 6/3/2025 11:00:17 AM

Main Details

Name

Hospital District No 6 of Harper Co, KS

Subdivision Name

Conway Springs Rural Health Clinic - Rural Health Clinic

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH171346-02

Medicare Provider Number

171346

Outpatient Facility Provider Number

178549

Additional Details

Current Program Status

Active

Registration Date

1/12/2018

Participating Start Date

4/1/2018

Participating Approval Date

1/17/2018

Last Recertification Date

8/12/2024

Contacts

Authorizing Official

Hospital District No. 6 of Harper County, Kansas
Sandra K Owen, CFO
(620) 914-1200 Ext: 2100

Primary Contact

Hospital District No 6 of Harper County, KS
Lori Allen, COO
(620) 914-1200 Ext: 2162

Addresses

Street Address

111 West Spring Avenue
Conway Springs, KS 67031

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?
Yes

State	Medicaid Number	NPI Number
KS	3003924480009,3003924480016	1013436260

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
CAH171346-01	Child	CAH	Hospital District No 6 of Harper Co, KS	Attica Rural Health Clinic - Rural Health Clinic	302 North Botkin Street	Attica	KS	Active
CAH171346-02	Child	CAH	Hospital District No 6 of Harper Co, KS	Conway Springs Rural Health Clinic - Rural Health Clinic	111 West Spring Avenue	Conway Springs	KS	Active
CAH171346-03	Child	CAH	Hospital District No 6 of Harper Co, KS	Harper Rural Health Clinic - Rural Health Clinic	700 W 13th Street	Harper	KS	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/13/2025 5:34 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		3003924480009	3/13/2025 5:34 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		KS	3/13/2025 5:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/13/2025 5:34 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		3003924480016	3/13/2025 5:34 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		KS	3/13/2025 5:34 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1013436260	3/13/2025 5:34 PM
Medicaid Billing	NPI: State	Insert	Change Request		KS	3/13/2025 5:34 PM
Details	Last Recertification Date	Update	Recertification	8/15/2023 9:24:44 AM	8/12/2024 11:55:38 AM	8/12/2024 11:55 AM
Details	Last Recertification Date	Update	Recertification	8/24/2022 10:05:44 AM	8/15/2023 9:24:44 AM	8/15/2023 9:24 AM
Details	Last Recertification Date	Update	Recertification	8/18/2021 11:08:17 AM	8/24/2022 10:05:44 AM	8/24/2022 10:05 AM
Details	Last Recertification Date	Update	Recertification	8/21/2020 9:03:27 AM	8/18/2021 11:08:17 AM	8/18/2021 11:08 AM
Contacts	Primary Contact	Update	Change Request	Allen, Lori Executive Director of Operations Hospital District No 6 of Harper County, KS 6209141200-2162	Allen, Lori COO Hospital District No 6 of Harper County, KS 6209141200-2162	3/9/2021 10:45 AM
Contacts	Authorizing Official	Update	AO Change Request	Owen, Sandra CFO Hospital District No 6 of Harper County, KS 6209141200-2100	Owen, Sandra K CFO Hospital District No. 6 of Harper County, Kansas 6209141200-2100	8/24/2020 6:31 AM
Details	Last Recertification Date	Update	Recertification	8/23/2019 10:11:28 AM	8/21/2020 9:03:27 AM	8/21/2020 9:03 AM
Contacts	Primary Contact	Update	Profile Change Request	Allen, Lori Executive Director of Operations Hospital District No 6 of Harper County, KS 6208425111-114	Allen, Lori Executive Director of Operations Hospital District No 6 of Harper County, KS 6209141200-2162	8/20/2020 9:39 AM
Contacts	Signed By	Update	Profile Change Request	Allen, Lori Executive Director of Operations Hospital District No 6 of Harper County, KS 6208425111-114	Allen, Lori Executive Director of Operations Hospital District No 6 of Harper County, KS 6209141200-2162	8/20/2020 9:39 AM
Details	Last Recertification Date	Update	Recertification	8/24/2018 9:42:45 AM	8/23/2019 10:11:28 AM	8/23/2019 10:11 AM
Contacts	Authorizing Official	Update	Profile Change Request	Owen, Sandra CFO/Interim CEO Hospital District No 6 of Harper County, KS 6208967324-314	Owen, Sandra CFO Hospital District No 6 of Harper County, KS 6209141200-2100	8/1/2019 6:34 PM
Contacts	Primary Contact	Update	Change Request	Owen, Sandra CFO/Interim CEO Hospital District No 6 of Harper County, KS 6208967324-314	Allen, Lori Executive Director of Operations Hospital District No 6 of Harper County, KS 6208425111-114	9/5/2018 10:53 AM
Contacts	Signed By	Update	Change Request	Allen, Lori Interim CEO, CFO Hospital District No 6 of Harper County, KS 6208425111-114	Allen, Lori Executive Director of Operations Hospital District No 6 of Harper County, KS 6208425111-114	9/5/2018 10:49 AM
Contacts	Authorizing Official	Update	AO Change Request	Allen, Lori Interim CEO, CFO Hospital District No 6 of Harper County, KS 6208425111-114	Owen, Sandra CFO/Interim CEO Hospital District No 6 of Harper County, KS 6208967324-314	8/27/2018 9:38 AM
Details	Last Recertification Date	Update	Recertification		8/24/2018 9:42:45 AM	8/24/2018 9:42 AM
Details	State	Update		Approved	Active	4/1/2018 12:00 AM
Contacts	Signed By	Insert	New Registration		Allen, Lori Interim CEO, CFO Hospital District No 6 of Harper County, KS 6208425111-114	1/17/2018 12:31 PM
Details	340B ID	Update	New Registration		CAH171346-02	1/17/2018 12:31 PM
Details	Entity Subname	Update	New Registration	Conway Springs Rural Health Clinic	Conway Springs Rural Health Clinic - Rural Health Clinic	1/17/2018 12:31 PM
Dates	Participating Approval Date	Update	New Registration		1/17/2018 12:31:51 PM	1/17/2018 12:31 PM
Details	State	Update	New Registration	Pending	Approved	1/17/2018 12:31 PM
Dates	Signed By Date	Update	New Registration		1/12/2018 12:55:37 PM	1/17/2018 12:31 PM
Dates	Start Date	Update	New Registration		4/1/2018 12:00:00 AM	1/17/2018 12:31 PM
Addresses	Main Address	Insert	New Registration		111 West Spring Avenue Conway Springs, KS 67031	1/12/2018 12:55 PM
Contacts	Authorizing Official	Insert	New Registration		Allen, Lori Interim CEO, CFO Hospital District No 6 of Harper County, KS 6208425111-114	1/12/2018 12:55 PM
Contacts	Primary Contact	Insert	New Registration		Owen, Sandra CFO/Interim CEO Hospital District No 6 of Harper County, KS 6208967324-314	1/12/2018 12:55 PM
Details	Last Recertification Date	Insert	New Registration			1/12/2018 12:55 PM
Details	Grant Number	Insert	New Registration			1/12/2018 12:55 PM
Details	340B ID	Insert	New Registration			1/12/2018 12:55 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/12/2018 12:55 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/12/2018 12:55 PM
Details	Medicare Provider Number	Insert	New Registration		171346	1/12/2018 12:55 PM
Details	Entity Name	Insert	New Registration		Hospital District No 6 of Harper Co, KS	1/12/2018 12:55 PM
Details	Program Code	Insert	New Registration		CAH	1/12/2018 12:55 PM
Details	Entity Subname	Insert	New Registration		Conway Springs Rural Health Clinic	1/12/2018 12:55 PM
Dates	Participating Approval Date	Insert	New Registration			1/12/2018 12:55 PM
Details	State	Insert	New Registration		Pending	1/12/2018 12:55 PM
Dates	Registration Date	Insert	New Registration		1/12/2018 12:55:35 PM	1/12/2018 12:55 PM
Dates	Signed By Date	Insert	New Registration			1/12/2018 12:55 PM
Dates	Start Date	Insert	New Registration			1/12/2018 12:55 PM
Terminations	Termination Comments	Insert	New Registration			1/12/2018 12:55 PM
Terminations	Termination Date	Insert	New Registration			1/12/2018 12:55 PM
Terminations	Termination Effective Date	Insert	New Registration			1/12/2018 12:55 PM
Terminations	Termination Reason	Insert	New Registration			1/12/2018 12:55 PM