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CAH431325-00 Mobridge Regional Hospital (Active)
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Main Details
Name
Mobridge Regional Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH431325-00
Medicare Provider Number
431325
Additional Details
Current Program Status
Active
Registration Date
7/2/2013
Participating Start Date
10/1/2013
Participating Approval Date
7/11/2013
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Mobridge Regional Hospital & Clinics
John J. Ayoub, CEO
(605) 845-8105
Primary Contact
Mobridge Regional Hospital
Lee Cordell, Director Of Pharmacy
(605) 845-8115
Addresses
Street Address
1401 10th Avenue West
Mobridge, SD 57601
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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