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CAH361331-04 Adena Fayette Medical Center (Active)
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Main Details
Name
Adena Fayette Medical Center
Subdivision Name
Adena Fayette Rural Health Clinic - OB/GYN
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH361331-04
Medicare Provider Number
361331
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/16/2017
Participating Start Date
1/1/2018
Participating Approval Date
10/18/2017
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Adena Health System
Katherine Edrington, Chief Operations Officer
(740) 779-7282
Primary Contact
Adena Health System
Fred Yingling, Director of Pharmacy
(740) 779-7648
Addresses
Street Address
1510 Columbus Avenue
MAB2 Suite 230
Washington Court House, OH 43160
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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