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DSH160122 Fort Madison Community Hospital (Terminated)
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Main Details
Name
Fort Madison Community Hospital
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH160122
Medicare Provider Number
160122
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/13/2014
Last Recertification Date
8/17/2020
Termination Date
Termination Reason
10/1/2021
Other
Contacts
Authorizing Official
Fort Madison Community Hospital
Daniel Earl Linhart, Vice President of Finance/CFO
(319) 376-2125
Primary Contact
Fort Madison Community Hospital
Cheryl Albin, Controller
(319) 376-2415
Addresses
Street Address
5445 Avenue O
Fort Madison, IA 52627
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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