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CAH011302-02 COLBERT COUNTY-NORTHWEST ALABAMA HEALTHCARE AUTHORITY (Terminated)
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Main Details
Name
COLBERT COUNTY-NORTHWEST ALABAMA HEALTHCARE AUTHORITY
Subdivision Name
MED EXPRESS-LITTLEVILLE
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH011302-02
Medicare Provider Number
011302
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/20/2015
Last Recertification Date
11/8/2017
Termination Date
Termination Reason
10/1/2018
Site closure
Contacts
Authorizing Official
HH Health System - Shoals LLC dba Helen Keller Hospital
Penny Westmoreland, CFO
(256) 386-4550
Primary Contact
Helen Keller Hospital
Jo R Spangler, IT Pharmacist
(256) 386-4468
Addresses
Street Address
1369 WEST T ALLEN HIGHWAY
RUSSELLVILLE, AL 35654
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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