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CAH161311-00 Hawarden Regional Healthcare (Active)
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Main Details
Name
Hawarden Regional Healthcare
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161311-00
Medicare Provider Number
161311
Additional Details
Current Program Status
Active
Registration Date
9/1/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/22/2011
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Hawarden Regional Healthcare
Jayson Pullman, CEO
(712) 551-3103
Primary Contact
Hawarden Regional Healthcare
Naomi Graves, Pharmacist
(712) 551-3173
Addresses
Street Address
1111 11th Street
Hawarden, IA 51023
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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