Covered Entity Details

CAH171384-05 NEWMAN MEMORIAL COUNTY HOSPITAL (Terminated) - information as of 4/26/2025 11:43:31 PM

Main Details

Name

NEWMAN MEMORIAL COUNTY HOSPITAL

Subdivision Name

NEWMAN REGIONAL HEALTH FAMILY MED - Family Medicine Clinic

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH171384-05

Medicare Provider Number

171384

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

4/2/2018

Participating Start Date

7/1/2018

Participating Approval Date

4/11/2018

Last Recertification Date

8/17/2018

Termination Date
Termination Reason

4/1/2019
Hospital Outpatient facility no longer eligible

Contacts

Authorizing Official

Newman Memorial County Hospital d/b/a Newman Regional Health
Holly R. French, CFO
(620) 343-6800 Ext: 22610

Primary Contact

Newman Regional Health
Ashley N Edwards, Pharmacist Director
(620) 343-6800

Addresses

Street Address

1301 W 12TH AVE STE 301
NEWMAN REGIONAL HEALTH FAMILY MEDICINE
EMPORIA, KS 66801-2590

Billing Address

Newman Regional Health Family Medicine
1201 W 12th Ave
Emporia, KS 66801

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
CAH171384-01	Child	CAH	NEWMAN MEMORIAL COUNTY HOSPITAL	NEWMAN REGIONAL HEALTH PEDIATRICS - Pediatric Clinic	1301 W 12TH AVE	EMPORIA	KS	Terminated
CAH171384-02	Child	CAH	NEWMAN MEMORIAL COUNTY HOSPITAL	NEWMAN REGIONAL HEALTH CARDIOLOGY - Cardiology Clinic	1301 W 12TH AVE	EMPORIA	KS	Terminated
CAH171384-03	Child	CAH	NEWMAN MEMORIAL COUNTY HOSPITAL	NEWMAN REGIONAL HEALTH ORTHOPEDIC - Orthopedic & Sports Medicine Clinic	1301 W 12TH AVE STE 105	EMPORIA	KS	Terminated
CAH171384-04	Child	CAH	NEWMAN MEMORIAL COUNTY HOSPITAL	NEWMAN REGIONAL HEALTH SURGICAL - General Surgery Clinic	1301 W 12th Ave, Suite 301	Emporia	KS	Terminated
CAH171384-05	Child	CAH	NEWMAN MEMORIAL COUNTY HOSPITAL	NEWMAN REGIONAL HEALTH FAMILY MED - Family Medicine Clinic	1301 W 12TH AVE STE 301	EMPORIA	KS	Terminated
CAH171384-06	Child	CAH	NEWMAN MEMORIAL COUNTY HOSPITAL	NEWMAN MEDICAL PARTNERS - NEWMAN REGIONAL HEALTH MEDICAL PARTNERS RHC	1301 W 12TH AVE.	Emporia	KS	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	French, Holly R. CFO Newman Memorial County Hospital d/b/a Newman Regional Health 6203436800-2610	French, Holly R. CFO Newman Memorial County Hospital d/b/a Newman Regional Health 6203436800-22610	3/9/2022 7:14 PM
Contacts	Signed By	Update	Profile Change Request	French, Holly R. CFO Newman Memorial County Hospital d/b/a Newman Regional Health 6203436800-2610	French, Holly R. CFO Newman Memorial County Hospital d/b/a Newman Regional Health 6203436800-22610	3/9/2022 7:14 PM
Details	State	Update		To Be Terminated	Terminated	4/1/2019 12:05 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		12/18/2018 12:00:00 AM	1/14/2019 7:32 AM
Details	State	Update	Termination Request	Active	To Be Terminated	1/14/2019 7:32 AM
Terminations	Termination Date	Update	Termination Request		4/1/2019 12:00:00 AM	1/14/2019 7:32 AM
Terminations	Termination Effective Date	Update	Termination Request		12/19/2018 12:00:00 AM	1/14/2019 7:32 AM
Terminations	Termination Reason	Update	Termination Request		Hospital Outpatient facility no longer eligible	1/14/2019 7:32 AM
Details	Last Recertification Date	Update	Recertification		8/17/2018 9:52:16 AM	8/17/2018 9:52 AM
Details	State	Update		Approved	Active	7/1/2018 12:00 AM
Contacts	Signed By	Insert	New Registration		French, Holly R. CFO Newman Memorial County Hospital d/b/a Newman Regional Health 6203436800-2610	4/11/2018 1:09 PM
Details	340B ID	Update	New Registration		CAH171384-05	4/11/2018 1:09 PM
Details	Entity Subname	Update	New Registration	NEWMAN REGIONAL HEALTH FAMILY MED	NEWMAN REGIONAL HEALTH FAMILY MED - Family Medicine Clinic	4/11/2018 1:09 PM
Dates	Participating Approval Date	Update	New Registration		4/11/2018 1:09:48 PM	4/11/2018 1:09 PM
Details	State	Update	New Registration	Pending	Approved	4/11/2018 1:09 PM
Dates	Signed By Date	Update	New Registration		4/6/2018 3:45:14 PM	4/11/2018 1:09 PM
Dates	Start Date	Update	New Registration		7/1/2018 12:00:00 AM	4/11/2018 1:09 PM
Addresses	Main Address	Insert	New Registration		1301 W 12TH AVE STE 301 NEWMAN REGIONAL HEALTH FAMILY MEDICINE EMPORIA, KS 66801-2590	4/2/2018 3:15 PM
Addresses	Billing Address	Insert	New Registration		Newman Regional Health Family Medicine 1201 W 12th Ave Emporia, KS 66801	4/2/2018 3:15 PM
Contacts	Authorizing Official	Insert	New Registration		French, Holly R. CFO Newman Memorial County Hospital d/b/a Newman Regional Health 6203436800-2610	4/2/2018 3:15 PM
Contacts	Primary Contact	Insert	New Registration		Edwards, Ashley N Pharmacist Director Newman Regional Health 6203436800	4/2/2018 3:15 PM
Details	Last Recertification Date	Insert	New Registration			4/2/2018 3:15 PM
Details	Grant Number	Insert	New Registration			4/2/2018 3:15 PM
Details	340B ID	Insert	New Registration			4/2/2018 3:15 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/2/2018 3:15 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/2/2018 3:15 PM
Details	Medicare Provider Number	Insert	New Registration		171384	4/2/2018 3:15 PM
Details	Entity Name	Insert	New Registration		NEWMAN MEMORIAL COUNTY HOSPITAL	4/2/2018 3:15 PM
Details	Program Code	Insert	New Registration		CAH	4/2/2018 3:15 PM
Details	Entity Subname	Insert	New Registration		NEWMAN REGIONAL HEALTH FAMILY MED	4/2/2018 3:15 PM
Dates	Participating Approval Date	Insert	New Registration			4/2/2018 3:15 PM
Details	State	Insert	New Registration		Pending	4/2/2018 3:15 PM
Dates	Registration Date	Insert	New Registration		4/2/2018 3:15:39 PM	4/2/2018 3:15 PM
Dates	Signed By Date	Insert	New Registration			4/2/2018 3:15 PM
Dates	Start Date	Insert	New Registration			4/2/2018 3:15 PM
Terminations	Termination Comments	Insert	New Registration			4/2/2018 3:15 PM
Terminations	Termination Date	Insert	New Registration			4/2/2018 3:15 PM
Terminations	Termination Effective Date	Insert	New Registration			4/2/2018 3:15 PM
Terminations	Termination Reason	Insert	New Registration			4/2/2018 3:15 PM