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CAH261336-00 IRON COUNTY HOSPITAL (Active)
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Main Details
Name
IRON COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH261336-00
Medicare Provider Number
261336
Additional Details
Current Program Status
Active
Registration Date
7/8/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/15/2016
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Iron County Hospital District
Brittany Mooney, Controller
(573) 546-8096
Primary Contact
Iron County Hospital District
Zachary Gibson, Pharmacist
(573) 546-8047
Addresses
Street Address
301 NORTH HWY 21
PILOT KNOB, MO 63663
Billing Address
IRON COUNTY HOSPITAL
P.O. BOX 548
PILOT KNOB, MO 63663
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/15/16 Participating 4/1/2011 until terminated effective 7/1/2013, reinstated effective 10/1/2016
08/15/2016
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