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CAH521344-00 Memorial Hospital of Boscobel (Active)
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Main Details
Name
Memorial Hospital of Boscobel
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521344-00
Medicare Provider Number
521344
Additional Details
Current Program Status
Active
Registration Date
1/10/2013
Participating Start Date
4/1/2013
Participating Approval Date
1/16/2013
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Memorial Hospital of Boscobel
Jennifer Boigenzahn, Finance Administrator
(608) 375-6228
Primary Contact
Gundersen Boscobel Area Hospital and Clinics
Tara Lee Wood, Pharmacy Director
(608) 375-6296
Addresses
Street Address
205 Parker St
Boscobel, WI 53805
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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