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CAH141338-00 Memorial Hospital (Active)
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Main Details
Name
Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141338-00
Medicare Provider Number
141338
Additional Details
Current Program Status
Active
Registration Date
12/30/2011
Participating Start Date
4/1/2012
Participating Approval Date
2/16/2012
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Randolph Hospital District dba Memorial Hospital
Brett Bollmann, Chief Executive Officer
(618) 826-4581 Ext: 1298
Primary Contact
Memorial Hospital
Morgan K. Bendorf, Chief Financial Officer
(618) 826-4581 Ext: 1463
Addresses
Street Address
1900 State Street
Chester, IL 62233
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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