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CAH171310-00 GREAT PLAINS OF CHEYENNE COUNTY INC (Active)
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Main Details
Name
GREAT PLAINS OF CHEYENNE COUNTY INC
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH171310-00
Medicare Provider Number
171310
Additional Details
Current Program Status
Active
Registration Date
10/8/2018
Participating Start Date
1/1/2019
Participating Approval Date
10/29/2018
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Cheyenne County Hospital
Jeremy Clingenpeel, CEO
(785) 332-2104 Ext: 119
Primary Contact
Great Plains of Cheyenne County, Inc
Tammi Sherlock, Pharmacy Nurse
(785) 332-2104 Ext: 129
Addresses
Street Address
210 W. FIRST STREET
ST. FRANCIS, KS 67756
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating start date 10/1/2014; Terminated 10/1/2018; Reinstated 1/12019.
10/22/2018
May 2025
May 2025
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