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SCH140210-01 HARRISBURG MEDICAL CENTER INC. (Terminated)
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Main Details
Name
HARRISBURG MEDICAL CENTER INC.
Subdivision Name
Equality Family Practice
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH140210-01
Medicare Provider Number
140210
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/20/2017
Last Recertification Date
9/8/2018
Termination Date
Termination Reason
7/1/2019
Site closure
Contacts
Authorizing Official
Harrisburg Medical Center, INc.
June Hayes, CFO
(618) 253-0141
Primary Contact
Harrisburg Medical Center
David Hurley, Director of Pharmacy
(618) 253-0243
Addresses
Street Address
183 North Lane Street
Equality, IL 62934
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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