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CAH151304-04 RUSH MEMORIAL HOSPITAL (Active)
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Main Details
Name
RUSH MEMORIAL HOSPITAL
Subdivision Name
RMH Women's Care
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH151304-04
Medicare Provider Number
151304
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
6/13/2024
Participating Start Date
7/1/2024
Participating Approval Date
6/14/2024
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Rush Memorial Hospital
BRADLEY SMITH, CEO
(765) 932-7513
Primary Contact
Rush Memorial Hospital
Greg Pratt, Director of Pharmacy
(765) 932-7497
Addresses
Street Address
110 E. 13th Street
RUSHVILLE, IN 46173-1116
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2015, terminated 10/1/2020. Reinstated 7/1/2024.
06/14/2024
Participating Start Date 1/1/2015, Termination Date 10/1/2020, Reinstatement 7/12024
04/18/2024
May 2025
May 2025
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