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CAH151315-01 CAMERON MEMORIAL COMMUNITY HOSPITAL (Active)
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Main Details
Name
CAMERON MEMORIAL COMMUNITY HOSPITAL
Subdivision Name
Rural Health Clinic II (Urgent Care)
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH151315-01
Medicare Provider Number
151315
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/5/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/7/2022
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, Inc.
Jonathan Crabill, Pharmacy Director
(260) 667-5427
Addresses
Street Address
1381 NORTH WAYNE STREET
ANGOLA, IN 46703
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 7/1/2011, terminated 10/1/2013. Reinstated 4/1/2022.
01/07/2022
April 2025
April 2025
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