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CAH141343-01 CRAWFORD HOSPITAL DISTRICT D/B/A CRAWFORD MEMORIAL HOSPITAL (Active)
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Main Details
Name
CRAWFORD HOSPITAL DISTRICT D/B/A CRAWFORD MEMORIAL HOSPITAL
Subdivision Name
ROBINSON RURAL HEALTH CLINIC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141343-01
Medicare Provider Number
141343
Outpatient Facility Provider Number
143429
Additional Details
Current Program Status
Active
Registration Date
11/30/2010
Participating Start Date
1/1/2011
Participating Approval Date
12/1/2010
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Crawford Memorial Hospital
MITZI MARTIN, BOARD VICE CHAIR
(618) 544-3131 Ext: 5123
Primary Contact
Crawford Memorial Hospital
Blake Potts, Director of Pharmacy
(618) 544-3131 Ext: 5380
Addresses
Street Address
1101 N. ALLEN STREET
ROBINSON, IL 62454
Billing Address
CRAWFORD MEMORIAL HOSPITAL
1002 N. ALLEN STREET
SUITE B
ROBINSON, IL 62454
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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