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CAH351319-00 Pembina County Memorial Hospital Assoc (Active)
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Main Details
Name
Pembina County Memorial Hospital Assoc
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH351319-00
Medicare Provider Number
351319
Additional Details
Current Program Status
Active
Registration Date
10/14/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/8/2013
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Pembina County Memorial Hospital
Katie Werner, CFO
(701) 265-6281
Primary Contact
Pembina County Memorial Hospital
Lisa LeTexier, CEO
(701) 265-6228
Addresses
Street Address
301 Mountain Street
Cavalier, ND 58220
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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