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CAH171368-00 MINNEOLA DISTRICT HOSPITAL (Active)
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Main Details
Name
MINNEOLA DISTRICT HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH171368-00
Medicare Provider Number
171368
Additional Details
Current Program Status
Active
Registration Date
4/2/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/21/2015
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Minneola District Hospital
Deborah A. Bruner, CEO
(620) 885-4264
Primary Contact
Minneola District Hospital NBR 2
Cassandra Pucket, AR Anaylst
(620) 885-4264
Addresses
Street Address
212 MAIN ST
MINNEOLA, KS 67865
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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