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CAH431306-02 Platte Community Memorial Hospital, Inc. (Active)
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Main Details
Name
Platte Community Memorial Hospital, Inc.
Subdivision Name
Geddes Medical Clinic
Type
Critical Access Hospital
Rural
No
340B ID
CAH431306-02
Medicare Provider Number
431306
Outpatient Facility Provider Number
433414
Additional Details
Current Program Status
Active
Registration Date
1/3/2013
Participating Start Date
4/1/2013
Participating Approval Date
2/14/2013
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Platte Community Memoria Hospial Inc
Mark Burket, CEO
(605) 337-3364
Primary Contact
Avera
Brandy Friesen, Pharmacy Regulatory Analyst
(605) 322-8446
Addresses
Street Address
322 Main Street
Geddes, SD 57342
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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