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CAH171331-00 KIOWA DISTRICT HOSPITAL (Active)
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Main Details
Name
KIOWA DISTRICT HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH171331-00
Medicare Provider Number
171331
Additional Details
Current Program Status
Active
Registration Date
4/16/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/19/2015
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Kiowa District Hospital
Janell L Goodno, CFO
(620) 825-4131 Ext: 1001
Primary Contact
Kiowa District Healthcare
Brandy Campbell, CNO
(620) 825-4131 Ext: 1067
Addresses
Street Address
1002 South 4th Street
KIOWA, KS 67070-0184
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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