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CAH521308-03 AMERY REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
AMERY REGIONAL MEDICAL CENTER
Subdivision Name
Luck Medical Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521308-03
Medicare Provider Number
521308
Outpatient Facility Provider Number
528516
Additional Details
Current Program Status
Active
Registration Date
4/12/2013
Participating Start Date
7/1/2013
Participating Approval Date
6/6/2013
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Amery Hospital & Clinic
Debra Rudquist, President
(715) 268-0300
Primary Contact
Westfields Hospital & Clinic
Darla Klementz, Director of Pharmacy
(715) 243-2758
Addresses
Street Address
2547 State Road 35
Suite 1
Luck, WI 54853
Billing Address
Amery Regional Medical Center
265 E Griffin St
Amery, WI 54001
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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