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CAH261301-00 ELLETT MEMORIAL HOSPITAL (Active)
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Main Details
Name
ELLETT MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH261301-00
Medicare Provider Number
261301
Additional Details
Current Program Status
Active
Registration Date
4/13/2016
Participating Start Date
7/1/2016
Participating Approval Date
5/2/2016
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Ellett Memorial Hospital
Laura Ninette Smith, CEO
(660) 476-5211
Primary Contact
Ellett Memorial Hospital
Beverly Johnson, Business Office Manager
(660) 476-2111 Ext: 5203
Addresses
Street Address
610 NORTH OHIO AVENUE
Appleton City, MO 64724
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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