340B Drug Pricing Program Database
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CAH141335-00 Mercy Harvard Hospital, Inc (Active)
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Main Details
Name
Mercy Harvard Hospital, Inc
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141335-00
Medicare Provider Number
141335
Additional Details
Current Program Status
Active
Registration Date
10/14/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/7/2013
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Mercy Health
Shannon Dunphy-Alexander, Senior Vice President / CFO
(608) 757-3126
Primary Contact
Mercyhealth
Clark Montgomery, System Manager of Pharmacy Business and 340B Program
(406) 698-8719
Addresses
Street Address
901 Grant Street
Harvard, IL 60033-1821
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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