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CAH161346-01 SIOUX CENTER HEALTH (Active)
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Main Details
Name
SIOUX CENTER HEALTH
Subdivision Name
HULL MEDICAL CLINIC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161346-01
Medicare Provider Number
161346
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
2/28/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/1/2011
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Sioux Center Health
Cory Nelson, CEO
(712) 722-8107
Primary Contact
Avera
Brandy Friesen, Pharmacy Regulatory Analyst
(605) 322-8446
Addresses
Street Address
807 MAIN
HULL, IA 51239
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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