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CAH351314-00 JACOBSON MEMORIAL HOSPITAL (Active)
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Main Details
Name
JACOBSON MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH351314-00
Medicare Provider Number
351314
Additional Details
Current Program Status
Active
Registration Date
4/6/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/19/2015
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Jacobson Memorial Hospital Care Center
Scott Alexander Brooks, Chief Executive Officer
(701) 584-2792
Primary Contact
Jacobson Memorial Hospital Care Center
Stephanie A LaBrie, CFO
(701) 584-2792
Addresses
Street Address
601 EAST STREET NORTH
ELGIN, ND 58533
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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