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CAH371307-00 CIMARRON MEMORIAL HOSPITAL (Active)
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Main Details
Name
CIMARRON MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH371307-00
Medicare Provider Number
371307
Additional Details
Current Program Status
Active
Registration Date
10/5/2021
Participating Start Date
10/14/2021
Participating Approval Date
10/14/2021
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Cimarron Memorial Hospital
Barbara Miller, Interim CEO
(580) 544-2501
Primary Contact
Cimarron Memorial Hospital
Debbie Brown, Purchasing Director
(580) 544-2501 Ext: 144
Addresses
Street Address
100 SOUTH ELLIS
BOISE CITY, OK 73933
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2016; Terminated 1/1/2018; Reinstated 10/14/2021.
10/14/2021
11/13/15 Participated starting 9/15/2010, terminated 10/1/2015 due to failure to recertify, reinstated based on new registration submitted in October 2015
11/13/2015
May 2025
May 2025
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