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CAH521354-01 SOUTHWEST HEALTH CENTER (Active)
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Main Details
Name
SOUTHWEST HEALTH CENTER
Subdivision Name
SOUTHWEST HEALTH PLATTEVILLE CLINIC - Family Practice, General Surgery
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521354-01
Medicare Provider Number
521354
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/8/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/13/2015
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Southwest Health Center, Inc.
Jesse William Sookochoff, Chief Financial Officer
(608) 342-4705
Primary Contact
Southwest Health
Jeff McDonald, Outpatient Pharmacy Director
(608) 342-6333
Addresses
Street Address
1450 EASTSIDE RD
PLATTEVILLE, WI 53818-9800
Billing Address
Southwest Health
1400 East Side Road
Platteville, WI 53818-9800
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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