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CAH161309-04 ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL d/b/a CHI Health Missouri Valley (Active)
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Main Details
Name
ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL d/b/a CHI Health Missouri Valley
Subdivision Name
CHI Health Missouri Valley Clinic
Type
Critical Access Hospital
Rural
No
340B ID
CAH161309-04
Medicare Provider Number
161309
Outpatient Facility Provider Number
161309
Additional Details
Current Program Status
Active
Registration Date
7/2/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/4/2014
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Missouri Valley
David J Jones, President
(816) 244-3695
Primary Contact
CommonSpirit Health - Central Region
Mitchell Schultz, RPh, 340b Regional Manager
(701) 928-0620
Addresses
Street Address
809 East Elm Street
Missouri Valley, IA 51555
Billing Address
ALEGENT HEALTH-COMMUNITY MEMORIAL HOSPITAL d/b/a CHI Health Missouri Valley
ATTN: 2210-5100146
PO Box 2400
Phoenix, AZ 85002
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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