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CAH171344-00 WILSON MEDICAL CENTER (Active)
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Main Details
Name
WILSON MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH171344-00
Medicare Provider Number
171344
Additional Details
Current Program Status
Active
Registration Date
1/13/2017
Participating Start Date
4/1/2017
Participating Approval Date
1/30/2017
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Wilson County Hospital
Lori Smith, CFO
(620) 325-8388
Primary Contact
WILSON COUNTY HOSPITAL
Travis A Coffield, Pharmacy Director
(620) 325-8334
Addresses
Street Address
2600 OTTAWA ROAD
NEODESHA, KS 66757
Billing Address
Wilson Medical Center
2600 Ottawa Road
P.O. Box 360
Neodesha, KS 66757
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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