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CAH061323-00 PROWERS MEDICAL CENTER (Active)
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Main Details
Name
PROWERS MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH061323-00
Medicare Provider Number
061323
Additional Details
Current Program Status
Active
Registration Date
8/2/2010
Participating Start Date
1/1/2011
Participating Approval Date
12/29/2010
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Prowers Medical Center
Steven A Gilgen, CFO
(719) 336-6753
Primary Contact
Prowers Medical Center
ROBIN THACKER, PHARMACIST
(719) 336-6740
Addresses
Street Address
401 KENDALL DRIVE
LAMAR, CO 81052
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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7/25/11 removed Medicaid#(was 05000700, 100102870A, ,04001538 ,04001392)
07/25/2011
May 2025
May 2025
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