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CAH101309-02 Hendry County Hospital Authority DBA Hendry Regional Medical Center (Active)
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Main Details
Name
Hendry County Hospital Authority DBA Hendry Regional Medical Center
Subdivision Name
Hendry Regional Convenient Care Center
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH101309-02
Medicare Provider Number
101309
Outpatient Facility Provider Number
103445
Additional Details
Current Program Status
Active
Registration Date
1/14/2014
Participating Start Date
4/1/2014
Participating Approval Date
1/29/2014
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Hendry Regional Medical Center
Troy Eller, CFO
(863) 902-3082
Primary Contact
Hendry Regional Medical Center
Duane Gwizdala, Pharmacy Director
(863) 902-3060
Addresses
Street Address
450 S. Main St Suite 1
Labelle, FL 33935
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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