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CAH531301-00 SOUTH BIG HORN HOSPITAL (Terminated)
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Main Details
Name
SOUTH BIG HORN HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH531301-00
Medicare Provider Number
531301
Additional Details
Current Program Status
Terminated
Registration Date
7/11/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/18/2017
Last Recertification Date
8/16/2023
Termination Date
Termination Reason
10/1/2024
Failure to recertify
Contacts
Authorizing Official
South Big Horn Hospital District dba Three Rivers Health
Joel Jackson, CEO
(307) 568-1423
Primary Contact
South Big Horn dba Three Rivers Health
Tamara L Sawyer, Compliance Officer
(307) 568-1423
Addresses
Street Address
388 HWY 20 SOUTH
BASIN, WY 82410
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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