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CAH321304-00 UNION COUNTY GEN. HOSPITAL (Active)
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Main Details
Name
UNION COUNTY GEN. HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH321304-00
Medicare Provider Number
321304
Additional Details
Current Program Status
Active
Registration Date
1/11/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/14/2019
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Union County General Hospital
Tammie Stump, Chief Executive Officer
(575) 374-7002
Primary Contact
Union County General Hospital
Melissa Cay Prante, Chief Financial Officer
(575) 374-7008
Addresses
Street Address
301 HARDING ST.
CLAYTON, NM 88415
Billing Address
Union County General Hospital
300 Wilson Street
Clayton, NM 88415-3304
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date (12/11/2014) until terminated effective date (10/01/2015), reinstatement effective date (04/01/2019)
01/14/2019
April 2025
April 2025
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