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CAH451375-00 Liberty Dayton Regional Medical Center (Active)
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Main Details
Name
Liberty Dayton Regional Medical Center
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH451375-00
Medicare Provider Number
451375
Additional Details
Current Program Status
Active
Registration Date
4/26/2012
Participating Start Date
7/1/2012
Participating Approval Date
5/30/2012
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Liberty Dayton Regional Medical Center
Rhonda Campbell, CEO
(936) 336-7316
Primary Contact
LIBERTY DAYTON REGIONAL MEDICAL CENTER
Aurora Davison, Pharmacy Director
(936) 336-7316 Ext: 116
Addresses
Street Address
1353 N.Travis St.
Liberty, TX 77575
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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