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CAH361316-02 BUCYRUS COMMUNITY HOSPITAL (Active)
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Main Details
Name
BUCYRUS COMMUNITY HOSPITAL
Subdivision Name
Provider Based Clinic - Hill Street Suite B (PBC 140B)
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH361316-02
Medicare Provider Number
361316
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/20/2017
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Avita Health System
Eric Draime, CFO
(419) 468-0501
Primary Contact
Avita Health System
Christina Barnes, Director of Pharmacy
(419) 468-0541
Addresses
Street Address
140 Hill Street
B
Bucyrus, OH 44820
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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