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CAH331302-02 ELIZABETHTOWN COMMUNITY HOSPITAL (Active)
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Main Details
Name
ELIZABETHTOWN COMMUNITY HOSPITAL
Subdivision Name
WESTPORT HEALTH CENTER
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH331302-02
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
6097 NY-9N/Route 22
WESTPORT, NY 12993
Billing Address
Elizabethtown Community Hospital
75 Park Street, PO Box 277
Elizabethtown, NY 12932
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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