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CAH141319-01 Henry District Hospital (Active)
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Main Details
Name
Henry District Hospital
Subdivision Name
Hammond Henry Hospital Medical Group -Kewanee - Family Practice
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141319-01
Medicare Provider Number
141319
Outpatient Facility Provider Number
148576
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
9/3/2024
Contacts
Authorizing Official
Hammond Henry Hospital
Wyatt Stanley Brieser, Director of Ancillary and Outpatient Services
(309) 944-9233
Primary Contact
Hammond Henry Hospital
April Switzer, Certified Pharmacy Technician
(309) 944-9141
Addresses
Street Address
1258 W. South Street
Suite 2
Kewanee, IL 61443-8300
Billing Address
Henry District Hospital
600 N. College Avenue
Geneseo, IL 61254-1099
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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