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CAH161352-00 CLARINDA REGIONAL HEALTH CENTER (Active)
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Main Details
Name
CLARINDA REGIONAL HEALTH CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161352-00
Medicare Provider Number
161352
Additional Details
Current Program Status
Active
Registration Date
9/23/2010
Participating Start Date
9/29/2010
Participating Approval Date
9/24/2010
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Clarinda Regional Health Center
Charles William Nordyke, Chief Executive Officer
(712) 542-8214
Primary Contact
Clarinda Regional Health Center
Crystal Hopf, Pharmacy Manager
(712) 542-8202
Addresses
Street Address
220 Essie Davison Drive
Clarinda, IA 51632
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/13/11 REMOVED MEDICAID#(136648946) 1/17/12 Updated addr (was 823 SOUTH 17TH STREET PO BOX 217) 1/17/12 Updated bill to (was CLARINDA REGIONAL HEALTH CENTER PO BOX 217)
01/17/2012
4/13/11 REMOVED MEDICAID#(136648946)
04/13/2011
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