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CAH451358-02 MEMORIAL HOSPITAL-SEMINOLE (Active)
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
Contacts
Authorizing Official
Seminole Memorial Hospital
Maegen Garner, Interim CEO
(432) 758-4814
Primary Contact
Seminole Hospital District
Sharay Cottrell, Human Resources Director
(432) 758-4986
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
8/18/2023
Addresses
Street Address
209 NW 8th Street
Seminole, TX 79360
Billing Address
Same as Street Address
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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