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CAH141307-00 PINCKNEYVILLE COMMUNITY HOSPITAL (Active)
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Main Details
Name
PINCKNEYVILLE COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141307-00
Medicare Provider Number
141307
Additional Details
Current Program Status
Active
Registration Date
11/18/2010
Participating Start Date
1/1/2011
Participating Approval Date
11/18/2010
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Pinckneyville Community Hospital District
KARA JO CARSON, CFO
(618) 357-2187 Ext: 5902
Primary Contact
Pinckneyville Community Hospital
JILL KELLERMAN, PHARMACIST, PHARMACY MANAGER
(618) 357-2187 Ext: 5934
Addresses
Street Address
5383 STATE ROUTE 154
PINCKNEYVILLE, IL 62274
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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