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CAH161374-00 SHELBY CO CHRIS A MYRTUE MEMORIAL HOSPITAL (Active)
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Main Details
Name
SHELBY CO CHRIS A MYRTUE MEMORIAL HOSPITAL
Subdivision Name
DBA MYRTUE MEDICAL CENTER
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161374-00
Medicare Provider Number
161374
Additional Details
Current Program Status
Active
Registration Date
2/17/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/2/2011
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Myrtue Medical Center
Barry Jacobsen, CEO
(712) 755-4315
Primary Contact
Myrtue Medical Center
Jessica Arlene Kuykendall, CPhT 340B coordinator
(712) 755-4411
Addresses
Street Address
1213 GARFIELD AVE
HARLAN, IA 51537
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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10/5/11 added Medicaid #
10/05/2011
April 2025
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