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CAH361324-00 SHELBY MEMORIAL HOSPITAL (Active)
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Main Details
Name
SHELBY MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH361324-00
Medicare Provider Number
361324
Additional Details
Current Program Status
Active
Registration Date
7/13/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/21/2017
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
OhioHealth
Curtis L Gingrich, President
(419) 526-8403
Primary Contact
OhioHealth
Dawn Williams, Site Manager
(419) 342-1746
Addresses
Street Address
199 West Main Street
Shelby, OH 44875
Billing Address
OhioHealth
PO Box 9
Columbus, OH 43216
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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