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CAH151320-01 JAY COUNTY HOSPITAL (Terminated)
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Main Details
Name
JAY COUNTY HOSPITAL
Subdivision Name
FAMILY PRACTICE OF JAY COUNTY
Type
Critical Access Hospital
Rural
No
340B ID
CAH151320-01
Medicare Provider Number
151320
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/10/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/14/2015
Last Recertification Date
11/3/2017
Termination Date
Termination Reason
4/1/2018
Loss of qualifying hospital status
Contacts
Authorizing Official
Jay County Hospital
Don Michael, CFO
(260) 726-7131 Ext: 1018
Primary Contact
Jay County Hospital
David Hyatt, CEO
(260) 726-7131
Addresses
Street Address
428 W VOTAW ST STE A
PORTLAND, IN 47371-1302
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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