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CAH101304-00 CALHOUN-LIBERTY HOSPITAL (Active)
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Main Details
Name
CALHOUN-LIBERTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH101304-00
Medicare Provider Number
101304
Additional Details
Current Program Status
Active
Registration Date
8/2/2010
Participating Start Date
8/10/2010
Participating Approval Date
8/3/2010
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Calhoun Liberty Hospital
Emily Brown, CEO
(850) 674-5411 Ext: 255
Primary Contact
JACKSON HOSPITAL
RODNEY ALLEN LEWIS, DIRECTOR, PHARMACY SERVICES
(850) 718-2609
Addresses
Street Address
20370 NE BURNS AVENUE
BLOUNTSTOWN, FL 32424
Billing Address
CALHOUN-LIBERTY HOSPITAL
20370 NE BURNS AVENUE
P.O. BOX 419
BLOUNTSTOWN, FL 32424
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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