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CAH031312-01 Bisbee Hospital Association dba Copper Queen Community Hospital (Active)
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Main Details
Name
Bisbee Hospital Association dba Copper Queen Community Hospital
Subdivision Name
Douglas Rural Health Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH031312-01
Medicare Provider Number
031312
Outpatient Facility Provider Number
033829
Additional Details
Current Program Status
Active
Registration Date
1/11/2013
Participating Start Date
4/1/2013
Participating Approval Date
3/11/2013
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Bisbee Hospital Association Dba Copper Queen Community Hospital
Heather A Lundstrom, Chief Financial Officer
(520) 432-6450
Primary Contact
Bisbee Hospital Association
Robert Seamon, CEO
(520) 432-6400
Addresses
Street Address
100 E 5th Street
Douglas, AZ 85607
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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