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CAH371325-00 CORDELL MEMORIAL HOSPITAL (Active)
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Main Details
Name
CORDELL MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH371325-00
Medicare Provider Number
371325
Additional Details
Current Program Status
Active
Registration Date
7/15/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/23/2019
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Cordell Memorial Hospital
Melinda K. Laird, CEO/CNO
(580) 832-3339
Primary Contact
Cordell Memorial Hospital
Georganna Buss, CFO
(580) 832-3339
Addresses
Street Address
1220 N GLENN ENGISH
CORDELL, OK 73632
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 10/1/2016. Reinstated 10/1/2019.
07/19/2019
May 2025
May 2025
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