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CAH171316-02 ANDERSON COUNTY HOSPITAL (Terminated)
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Main Details
Name
ANDERSON COUNTY HOSPITAL
Subdivision Name
FAMILY CARE CENTER SOUTH
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH171316-02
Medicare Provider Number
171316
Outpatient Facility Provider Number
178586
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/22/2015
Last Recertification Date
8/19/2020
Termination Date
Termination Reason
10/1/2020
Site closure
Contacts
Authorizing Official
Anderson County Hospital
VICKI MILLS, CHIEF FINANCIAL OFFICER
(785) 204-4043
Primary Contact
ACH
Emily McAdam, Pharmacy Coordinator
(785) 204-8096
Addresses
Street Address
421 S Maple
309 N Pine Street
COLONY, KS 66015-7279
Billing Address
Saint Luke's Health System Central Accounts Payable (CAP)
P.O. BOX 5870
Kansas City, MO 64171-0870
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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