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CAH161375-00 BUENA VISTA REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
BUENA VISTA REGIONAL MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161375-00
Medicare Provider Number
161375
Additional Details
Current Program Status
Active
Registration Date
8/4/2010
Participating Start Date
8/18/2010
Participating Approval Date
8/18/2010
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Buena Regional Medical Center
Krista L. Ketcham, Chief Financial Officer
(712) 213-8603
Primary Contact
Buena Vista Regional Medical Center
JON David MCKENNA, DIRECTOR OF PHARMACY
(712) 213-8695
Addresses
Street Address
1525 W. 5TH ST.
STORM LAKE, IA 50588
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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