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CAH261311-05 Mercy Hospital Perry (Active)
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Main Details
Name
Mercy Hospital Perry
Subdivision Name
Mercy Infusion Center
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH261311-05
Medicare Provider Number
261311
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/16/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/17/2017
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
Mercy
Sherry Clouse Day, VP Finance - Mercy CAH
(417) 820-8439
Primary Contact
Mercy Shared Services
Mike Loftus, Director-Hospital Pharmacy
(417) 820-3487
Addresses
Street Address
210 Hospital Ln
Suite 203
Perryville, MO 63775
Billing Address
Perry County Memorial Hospital
434 N West St
Perryville, MO 63775
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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