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SCH450073-02 DM Cogdell Memorial Hospital (Terminated)
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Main Details
Name
DM Cogdell Memorial Hospital
Subdivision Name
DM Cogdell Family Clinic
Type
Sole Community Hospital
Rural
No
340B ID
SCH450073-02
Medicare Provider Number
450073
Outpatient Facility Provider Number
458827
Additional Details
Current Program Status
Terminated
Registration Date
4/2/2013
Participating Start Date
7/1/2013
Participating Approval Date
5/3/2013
Last Recertification Date
8/15/2016
Termination Date
Termination Reason
10/1/2016
Change of covered entity type
Contacts
Authorizing Official
Scurry County Hospital District
John H. Everett, COO
(325) 574-7439
Primary Contact
Scurry County Hospital District
John H. Everett, COO
(325) 574-7439
Addresses
Street Address
5009 College Ave
Snyder, TX 79549
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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