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CAH281313-00 Gothenburg Memorial Hospital (Active)
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Main Details
Name
Gothenburg Memorial Hospital
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH281313-00
Medicare Provider Number
281313
Additional Details
Current Program Status
Active
Registration Date
10/11/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/3/2013
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Gothenburg Memorial Hospital
Michael Brant, CEO
(308) 537-3661
Primary Contact
Gothenburg Memorial Hospital
Johnna Richter, Pharmacist
(308) 537-1050
Addresses
Street Address
910 20th Street
Gothenburg, NE 69138
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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