340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CAH161374-03 SHELBY CO CHRIS A MYRTUE MEMORIAL HOSPITAL (Active)
Print
Main Details
Name
SHELBY CO CHRIS A MYRTUE MEMORIAL HOSPITAL
Subdivision Name
Myrtue Medical Center Elk Horn RHC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161374-03
Medicare Provider Number
161374
Outpatient Facility Provider Number
161374
Additional Details
Current Program Status
Active
Registration Date
7/8/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/4/2014
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Myrtue Medical Center
Barry Jacobsen, CEO
(712) 755-4315
Primary Contact
Myrtue Medical Center
Jessica Arlene Kuykendall, CPhT 340B coordinator
(712) 755-4411
Addresses
Street Address
4022 Main St.
Elk Horn, IA 51531
Billing Address
Myrtue Medical Center
1213 Garfield Ave.
Harlan, IA 51537
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session