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CAH141351-03 County of Clay DBA Clay County Hospital (Approved)
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Main Details
Name
County of Clay DBA Clay County Hospital
Subdivision Name
COUNTY OF CLAY - Clay City Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141351-03
Medicare Provider Number
141351
Outpatient Facility Provider Number
148558
Additional Details
Current Program Status
Approved
Registration Date
4/8/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/9/2025
Last Recertification Date
Contacts
Authorizing Official
Clay County Hospital
Jason Harris, Director of Pharmacy
(618) 662-1653
Primary Contact
Clay County Hospital
Robert Raymond Sellers, President
(618) 662-1628
Addresses
Street Address
939 SUNSET RD SW
CLAY CITY, IL 62824-1113
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
June 2025
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