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CAH141344-01 LAWRENCE COUNTY MEMORIAL HOSPITAL (Active)
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Main Details
Name
LAWRENCE COUNTY MEMORIAL HOSPITAL
Subdivision Name
Lawrence County Memorial Hospital Primary Care Clinic
Type
Critical Access Hospital
Rural
No
340B ID
CAH141344-01
Medicare Provider Number
141344
Outpatient Facility Provider Number
143499
Additional Details
Current Program Status
Active
Registration Date
10/3/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/5/2016
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Lawrence County Memorial Hospital
Carl H Aten, Board Chairman
(618) 843-8424
Primary Contact
Lawrence County Memorial Hospital
Shana C Strange, CFO
(618) 943-7202
Addresses
Street Address
2111 Lexington Avenue
Lawrenceville, IL 62439-2085
Billing Address
Lawrence County Memorial Hospital Primary Care Clinic
2200 State Street
Lawrenceville, IL 62439
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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