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CAH061305-00 East Phillips County Hospital District d/b/a MELISSA MEMORIAL HOSPITAL (Active)
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Main Details
Name
East Phillips County Hospital District d/b/a MELISSA MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH061305-00
Medicare Provider Number
061305
Additional Details
Current Program Status
Active
Registration Date
10/11/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/11/2014
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
East Phillips County Hospital District dba Melissa Memorial Hospital
Stephanie Lopez, Business Office Manager
(970) 854-2241 Ext: 2045
Primary Contact
East Phillips County Hospital District dba Melissa Memorial Hospital
Mary Amy Kleve, Pharmaist
(907) 854-2222
Addresses
Street Address
1001 East JOHNSON ST
HOLYOKE, CO 80734
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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