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CAH141351-00 County of Clay DBA Clay County Hospital (Active)
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Main Details
Name
County of Clay DBA Clay County Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141351-00
Medicare Provider Number
141351
Additional Details
Current Program Status
Active
Registration Date
8/9/2012
Participating Start Date
10/1/2012
Participating Approval Date
8/21/2012
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Clay County Hospital
Jason Harris, Director of Pharmacy
(618) 662-1653
Primary Contact
Clay County Hospital
Robert Raymond Sellers, President
(618) 662-1628
Addresses
Street Address
911 Stacy Burk Dr.
Flora, IL 62839-3241
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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