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CAH281359-01 MEMORIAL COMMUNITY HOSPITAL (Active)
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Main Details
Name
MEMORIAL COMMUNITY HOSPITAL
Subdivision Name
Blair Clinic MCH Physicians
Type
Critical Access Hospital
Rural
No
340B ID
CAH281359-01
Medicare Provider Number
281359
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/6/2015
Participating Start Date
4/1/2015
Participating Approval Date
2/10/2015
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
MEMORIAL COMMUNITY HOSPITAL
JENNIFER NEWBY, Operations Director, Finance and Support Services
(402) 426-1295
Primary Contact
MEMORIAL COMMUNITY HOSPITAL
BRAD STUVA, PHARMACY MANAGER
(402) 426-1159
Addresses
Street Address
812 North 22nd Street
Blair, NE 68008
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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