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CAH451358-02 MEMORIAL HOSPITAL-SEMINOLE (Active)
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Main Details
Name
MEMORIAL HOSPITAL-SEMINOLE
Subdivision Name
Rural Health Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH451358-02
Medicare Provider Number
451358
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/28/2019
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Seminole Memorial Hospital
Maegen Garner, Interim CEO
(432) 758-4814
Primary Contact
Seminole Memorial Hospital
Deborah Anne Dabbs, Compliance Officer
(432) 758-4868
Addresses
Street Address
209 NW 8th Street
Seminole, TX 79360
Billing Address
CAH PHCY SRVCS DIV 16
13651 DUBLIN COURT
Stafford, TX 77477
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date 01/01/2016) ) until terminated effective date (10/1/2018), reinstatement effective date (04/01/2019)
01/16/2019
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