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CAH151315-00 CAMERON MEMORIAL COMMUNITY HOSPITAL (Active)
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Main Details
Name
CAMERON MEMORIAL COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH151315-00
Medicare Provider Number
151315
Additional Details
Current Program Status
Active
Registration Date
5/27/2011
Participating Start Date
1/1/2014
Participating Approval Date
6/22/2011
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Cameron Memorial Community Hospital, Inc.
Angela Logan, CEO
(260) 667-5735
Primary Contact
Cameron Memorial Community Hospital
Stacy Thomas, Director of Pharmacy
(260) 667-2848
Addresses
Street Address
416 EAST MAUMEE STREET
ANGOLA, IN 46703-2015
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/14/13 participating 7/1/11 thru 9/30/13, not participating 10/1/13 thru 12/31/13 due to failure to recertify, re-instated based on an on-line registration submitted (TERMINATION DATE AND RELATED FIELDS SET TO NULL)
11/14/2013
April 2025
April 2025
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