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CAH521358-00 DOOR COUNTY MEMORIAL HOSPITAL (Active)
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Main Details
Name
DOOR COUNTY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521358-00
Medicare Provider Number
521358
Additional Details
Current Program Status
Active
Registration Date
6/14/2011
Participating Start Date
7/1/2011
Participating Approval Date
6/15/2011
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Door County Memorial Hospital
Brian C. Stephens, CEO
(920) 746-3737
Primary Contact
Door County Memorial Hospital
Amy Konop, Pharmacist
(920) 746-3633
Addresses
Street Address
323 SOUTH 18TH AVENUE
STURGEON BAY, WI 54235
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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