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CAH241306-01 Renville County Hospital & Clinics (Terminated)
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Main Details
Name
Renville County Hospital & Clinics
Subdivision Name
Renville County Hospital & Clinics - Olivia Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH241306-01
Medicare Provider Number
241306
Outpatient Facility Provider Number
243442
Additional Details
Current Program Status
Terminated
Registration Date
8/20/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/4/2012
Last Recertification Date
9/1/2016
Termination Date
Termination Reason
1/1/2017
Site closure
Contacts
Authorizing Official
Olivia Hospital & Clinic
Nathan Blad, President
(320) 523-3575
Primary Contact
Olivia Hospital & Clinic
Nathan Blad, President
(320) 523-3575
Addresses
Street Address
100 Healthy Way
Olivia, MN 56277-1117
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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