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CAH141338-02 Memorial Hospital (Active)
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Main Details
Name
Memorial Hospital
Subdivision Name
CHESTER CLINIC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141338-02
Medicare Provider Number
141338
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/8/2016
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Randolph Hospital District dba Memorial Hospital
Brett Bollmann, Chief Executive Officer
(618) 826-4581 Ext: 1298
Primary Contact
Memorial Hospital
Morgan K. Bendorf, Chief Financial Officer
(618) 826-4581 Ext: 1463
Addresses
Street Address
1900 State Street
CHESTER, IL 62233-1116
Billing Address
Memorial Hospital
1900 State Street
Chester, IL 62233
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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