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SCH170150-00 SOUTH CENTRAL KS REGIONAL MEDICAL CT (Terminated)
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Main Details
Name
SOUTH CENTRAL KS REGIONAL MEDICAL CT
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH170150-00
Medicare Provider Number
170150
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/21/2015
Last Recertification Date
8/23/2023
Termination Date
Termination Reason
1/1/2024
Other
Contacts
Authorizing Official
SCKRMC
Debbie Hockenbury, CFO
(620) 441-5924
Primary Contact
South Central Kansas Regional Medical Center
Homer Mah, Pharmacist
(620) 441-5725
Addresses
Street Address
6401 Patterson Parkway
ARKANSAS CITY, KS 67005
Billing Address
South Central Kansas Regional Medical Center
6401 Patterson Parkway
Arkansas City, KS 67005
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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