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CAH161380-00 ELLSWORTH MUNICIPAL HOSPITAL (Active)
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Main Details
Name
ELLSWORTH MUNICIPAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161380-00
Medicare Provider Number
161380
Additional Details
Current Program Status
Active
Registration Date
8/26/2010
Participating Start Date
9/1/2010
Participating Approval Date
8/26/2010
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Ellsworth Municipal Hospital dba Hansen Family Hospital
George Von Mock, CEO
(641) 648-7010
Primary Contact
Ellsworth Municipal Hospital dba Hansen Family Hospital
Ann Beecher, Pharmacy Director
(641) 648-7033
Addresses
Street Address
920 S OAK ST
DBA HANSEN FAMILY HOSPITAL
IOWA FALLS, IA 50126-9506
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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