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CAH171385-04 Coffey County Hospital (Active)
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Main Details
Name
Coffey County Hospital
Subdivision Name
LE ROY MEDICAL CLINIC - PRIMARY CARE
Type
Critical Access Hospital
Rural
No
340B ID
CAH171385-04
Medicare Provider Number
171385
Outpatient Facility Provider Number
173984
Additional Details
Current Program Status
Active
Registration Date
1/12/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/17/2018
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Coffey Health System
Samantha Jo Kuhlmann, Director of Informatics
(620) 364-2121 Ext: 4221
Primary Contact
Coffey County Hospital
Craig Howard Stukey, Senior Accountant
(620) 364-2121 Ext: 4293
Addresses
Street Address
538 C STREET
LE ROY, KS 66857
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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