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RRC520076-00 BEAVER DAM COMMUNITY HOSPITALS (Active)
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Main Details
Name
BEAVER DAM COMMUNITY HOSPITALS
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC520076-00
Medicare Provider Number
520076
Additional Details
Current Program Status
Active
Registration Date
7/3/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/9/2024
Last Recertification Date
Contacts
Authorizing Official
Marshfield Clinic Health System
Janette Townsend, CFO
(775) 750-2197
Primary Contact
Marshfield Clinic Health System
Girish Kaimal, Chief Pharmacy Officer
(623) 296-2075
Addresses
Street Address
707 SOUTH UNIVERSITY AVENUE
BEAVER DAM, WI 53916
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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