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CAH161363-00 Montgomery County Memorial Hospital (Active)
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Main Details
Name
Montgomery County Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161363-00
Medicare Provider Number
161363
Additional Details
Current Program Status
Active
Registration Date
2/28/2012
Participating Start Date
4/1/2012
Participating Approval Date
3/30/2012
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Montgomery County Memorial Hospital
Bryant John Blay, CFO
(712) 623-7152
Primary Contact
Montgomery County Memorial Hospital
Sherstin Kay Willyerd, Director of Pharmacy
(712) 623-7116
Addresses
Street Address
2301 Eastern Avenue
Red Oak, IA 51566
Billing Address
Montgomery County Memorial Hospital
P O Box 498
Red Oak, IA 51566
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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