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SCH330211-08 Claxton Hepburn Medical Center (Terminated)
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Main Details
Name
Claxton Hepburn Medical Center
Subdivision Name
CLAXTON HEPBURN MEDICAL CENTER / oncology
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH330211-08
Medicare Provider Number
330211
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/20/2017
Last Recertification Date
8/17/2021
Termination Date
Termination Reason
4/1/2022
Change of covered entity type
Contacts
Authorizing Official
Claxton-Hepburn Medical Center
Richard Duvall, CEO
(315) 713-5237
Primary Contact
City of Ogdensburg
Sarah Purdy, city manager
(315) 393-6100
Addresses
Street Address
5 LYONS PLACE
OGDENSBURG, NY 13669
Billing Address
Claxton Hepburn Medical Center
214 King Street
Ogdensburg, NY 13669
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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