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CAH161313-00 Genesis Medical Center, DeWitt (Active)
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Main Details
Name
Genesis Medical Center, DeWitt
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161313-00
Medicare Provider Number
161313
Additional Details
Current Program Status
Active
Registration Date
11/17/2011
Participating Start Date
1/1/2012
Participating Approval Date
12/9/2011
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Genesis Medical Center Aledo
Edward Rogalski, Administrator
(309) 582-3700
Primary Contact
Genesis Health System
Christian Joseph Erickson, Pharmacy Supervisor
(563) 659-4286
Addresses
Street Address
1118 11th Street
DeWitt, IA 52742
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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