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CAH331302-01 ELIZABETHTOWN COMMUNITY HOSPITAL (Active)
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Main Details
Name
ELIZABETHTOWN COMMUNITY HOSPITAL
Subdivision Name
ELIZABETHTOWN COMMUNITY HEALTH CENTER
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH331302-01
Medicare Provider Number
331302
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
9/30/2010
Participating Start Date
9/30/2010
Participating Approval Date
9/30/2010
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Elizabethtown Community Hospital
Scott Alan Comeau, CFO
(802) 388-4752
Primary Contact
Porter Medical Center
Renee Mosier, Pharmacy Director
(802) 388-4701 Ext: 5624
Addresses
Street Address
66 PARK STREET
ELIZABETHTOWN, NY 12932
Billing Address
ELIZABETHTOWN COMMUNITY HOSPITAL
75 Park Street, P.O. BOX 277
ELIZABETHTOWN, NY 12932
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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