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CAH361325-12 GALION COMMUNITY HOSPITAL (Active)
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Main Details
Name
GALION COMMUNITY HOSPITAL
Subdivision Name
Rural Health Clinic - Mansfield Street (RHC 1323) - Family Med
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH361325-12
Medicare Provider Number
361325
Outpatient Facility Provider Number
363991
Additional Details
Current Program Status
Active
Registration Date
10/15/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/2/2015
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Avita Health System
ERIC DRAIME, CHIEF FINANCIAL OFFICER
(419) 468-0501
Primary Contact
Avita Health System
Christina Barnes, Director of Pharmacy
(419) 468-0541
Addresses
Street Address
1323 E Mansfield Street
Bucyrus, OH 44820
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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