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CAH261333-00 Pike County Memorial Hospital (Active)
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Main Details
Name
Pike County Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH261333-00
Medicare Provider Number
261333
Additional Details
Current Program Status
Active
Registration Date
5/29/2012
Participating Start Date
7/1/2012
Participating Approval Date
6/7/2012
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Pike County Memorial Hospital
Tylie Mills, Chief Executive Officer
(573) 754-5531 Ext: 105
Primary Contact
Pike County Memorial Hospital
Jeffrey VanHorn, CFO
(573) 754-5531
Addresses
Street Address
2305 Georgia Street
Louisiana, MO 63353
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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