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CAH141316-23 HOOPESTON COMMUNITY MEMORIAL HOSPITA (Terminated)
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Main Details
Name
HOOPESTON COMMUNITY MEMORIAL HOSPITA
Subdivision Name
CHARLOTTE ANN RUSSELL MEDICAL CENTE / Pulmonary Function lab
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141316-23
Medicare Provider Number
141316
Outpatient Facility Provider Number
143448
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/13/2014
Last Recertification Date
8/31/2015
Termination Date
Termination Reason
4/1/2016
Site closure
Contacts
Authorizing Official
Carle Foundation Hospital
Dennis P. Hesch, Executive VP and CFO
(217) 326-8231
Primary Contact
Carle Health
Linda Fred, Vice President of Pharmacy Services
(217) 902-5803
Addresses
Street Address
801 East Orange Street
Hoopeston, IL 60942-1802
Billing Address
The Carle Foundation Hospital
611 West Park Street
Urbana, IL 61801-2529
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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