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CAH281360-00 BOX BUTTE GENERAL HOSPITAL (Active)
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Main Details
Name
BOX BUTTE GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH281360-00
Medicare Provider Number
281360
Additional Details
Current Program Status
Active
Registration Date
4/9/2019
Participating Start Date
7/1/2019
Participating Approval Date
6/4/2019
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Box Butte General Hospital
Lori Mazanec, Chief Executive Officer
(308) 762-6660
Primary Contact
Box Butte General Hospital
Matthew Pinneo, Pharmacy Manager/Pharmacist
(308) 762-6660 Ext: 2101
Addresses
Street Address
2101 BOX BUTTE AVENUE
ALLIANCE, NE 69301
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 10/1/2015; Reinstated 7/1/2019.
05/31/2019
April 2025
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