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CAH161367-02 PELLA REGIONAL HEALTH CENTER (Terminated)
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Main Details
Name
PELLA REGIONAL HEALTH CENTER
Subdivision Name
MONROE FAMILY HEALTH CENTER
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161367-02
Medicare Provider Number
161367
Outpatient Facility Provider Number
163449
Additional Details
Current Program Status
Terminated
Registration Date
11/30/2010
Participating Start Date
1/1/2011
Participating Approval Date
12/1/2010
Last Recertification Date
8/20/2018
Termination Date
Termination Reason
10/1/2019
Site closure
Contacts
Authorizing Official
Pella Regional Health Center
Dawnett Willis, Chief Ancillary Services Officer
(641) 621-2480
Primary Contact
Pella Regional Health Center
Mindi Chamberlain, Pharmacy Director
(641) 628-6616
Addresses
Street Address
100 E. SHERMAN
MONROE, IA 50170
Billing Address
MONROE FAMILY HEALTH CENTER
C/O Pella Regional Health Center
404 Jefferson
PELLA, IA 50219
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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