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CAH161300-00 BAUM HARMON MERCY HOSPITAL DBA MERCYONE PRIMGHAR MEDICAL CENTER (Terminated)
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Main Details
Name
BAUM HARMON MERCY HOSPITAL DBA MERCYONE PRIMGHAR MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161300-00
Medicare Provider Number
161300
Additional Details
Current Program Status
Terminated
Registration Date
9/30/2010
Participating Start Date
1/1/2011
Participating Approval Date
10/7/2010
Last Recertification Date
9/4/2024
Termination Date
Termination Reason
10/1/2024
Site closure
Contacts
Authorizing Official
MercyOne
Jesica Hanson, VP of Finance
(712) 279-5850
Primary Contact
MercyOne
Brett Bieber, Director of Pharmacy
(712) 279-5992
Addresses
Street Address
255 NORTH WELCH AVENUE
PRIMGHAR, IA 51245
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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