340B Drug Pricing Program Database
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CAH521353-00 Cumberland Memorial Hospital, Inc. (Active)
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Main Details
Name
Cumberland Memorial Hospital, Inc.
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521353-00
Medicare Provider Number
521353
Additional Details
Current Program Status
Active
Registration Date
10/5/2012
Participating Start Date
1/1/2013
Participating Approval Date
10/24/2012
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Cumberland Memorial Hospital
Angie Martens, CFO
(715) 822-7254
Primary Contact
Cumberland Memorial Hospital, Inc.
Tyler Jordan Geerdes, Director of Pharmacy
(715) 822-7112
Addresses
Street Address
1705 16th Ave
Cumberland, WI 54829
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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