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CAH161358-03 Wayne County Hospital (Active)
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Main Details
Name
Wayne County Hospital
Subdivision Name
Humeston Family Medical Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161358-03
Medicare Provider Number
161358
Outpatient Facility Provider Number
168548
Additional Details
Current Program Status
Active
Registration Date
7/3/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/4/2014
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Wayne County Hospital
Denise Hook, CFO
(641) 872-5277
Primary Contact
Wayne County Hospital
Phillip R Masters, Pharmacist
(641) 872-5262
Addresses
Street Address
109 Broad Street
Humeston, IA 50123
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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