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CAH451379-00 CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY (Active)
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Main Details
Name
CORYELL COUNTY MEMORIAL HOSPITAL AUTHORITY
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH451379-00
Medicare Provider Number
451379
Additional Details
Current Program Status
Active
Registration Date
9/16/2010
Participating Start Date
9/29/2010
Participating Approval Date
9/16/2010
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Coryell Health
Kneeley Lawdermilk, CFO
(254) 248-6276
Primary Contact
Coryell Health
Emily Dossey, Director of Contracts and Credentialing
(248) 248-6245
Addresses
Street Address
1507 W MAIN ST
GATESVILLE, TX 76528-1024
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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