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CAH031302-00 NORTHERN COCHISE COMMUNITY HOSPITAL, INC. (Active)
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Main Details
Name
NORTHERN COCHISE COMMUNITY HOSPITAL, INC.
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH031302-00
Medicare Provider Number
031302
Additional Details
Current Program Status
Active
Registration Date
8/3/2010
Participating Start Date
8/5/2010
Participating Approval Date
8/3/2010
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Northern Cochise Community Hospital
James G Kraykovich, Director of Finance
(520) 766-6450
Primary Contact
Northern Cochise Community Hospital
Todd R Raehtz, Pharmacist in Charge
(734) 260-6387
Addresses
Street Address
901 WEST REX ALLEN DRIVE
WILLCOX, AZ 85643
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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