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CAH161369-00 CRAWFORD COUNTY MEMORIAL HOSPITAL (Active)
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Main Details
Name
CRAWFORD COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161369-00
Medicare Provider Number
161369
Additional Details
Current Program Status
Active
Registration Date
2/24/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/17/2011
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
CRAWFORD COUNTY MEMORIAL HOSPITAL
Rachel Melby, CHIEF FINANCIAL OFFICER
(712) 265-2505
Primary Contact
Crawford County Memorial Hospital
Zachary I Jepsen, 340B Coordinator
(712) 371-2551
Addresses
Street Address
100 MEDICAL PARKWAY
DENISON, IA 51442-2210
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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