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CAH061327-01 Southwest Memorial Hospital (Active)
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Main Details
Name
Southwest Memorial Hospital
Subdivision Name
Southwest Medical Group Primary Care Suites B,C, D
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH061327-01
Medicare Provider Number
061327
Outpatient Facility Provider Number
068506
Additional Details
Current Program Status
Active
Registration Date
2/9/2012
Participating Start Date
4/1/2012
Participating Approval Date
3/15/2012
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Southwest Health System970-560-4956
Heather J Frazier, Southwest Memorial Hospital Controller
(970) 564-2117
Primary Contact
Southwest Memorial Hospital
Marc J Meyer, Director of Pharmacy
(970) 564-2194
Addresses
Street Address
1311A N Mildred Rd
Cortez, CO 81321
Billing Address
Southwest Health System
1311 N. Mildred Rd.
Cortez, CO 81321
Comments
Medicaid Billing
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Contract Pharmacies
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