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SCH140210-03 HARRISBURG MEDICAL CENTER INC. (Terminated)
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Main Details
Name
HARRISBURG MEDICAL CENTER INC.
Subdivision Name
GALATIA PRIMARY CARE - General Health Care
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH140210-03
Medicare Provider Number
140210
Outpatient Facility Provider Number
148560
Additional Details
Current Program Status
Terminated
Registration Date
1/11/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/25/2018
Last Recertification Date
8/26/2019
Termination Date
Termination Reason
7/1/2020
Site closure
Contacts
Authorizing Official
Harrisburg Medical Center, INc.
June Hayes, CFO
(618) 253-0141
Primary Contact
Harrisburg Medical Center, Inc.
Cody Sandusky, Director of Pharmacy
(618) 253-0263
Addresses
Street Address
124 E MAIN ST
GALATIA, IL 62935-1300
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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