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CAH451386-01 Moore County Hospital District d/b/a Memorial Hospital (Active)
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Main Details
Name
Moore County Hospital District d/b/a Memorial Hospital
Subdivision Name
Moore County General Surgery - General surgery
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH451386-01
Medicare Provider Number
451386
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/8/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/28/2019
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Moore County Hospital District
JEFF Ray TURNER, CEO
(806) 935-7171
Primary Contact
Moore County Hospital District
Ashleigh Dozier Wiswell, Chief Operations Officer
(806) 934-7802
Addresses
Street Address
1405 E 1ST ST
Suite 201
Dumas, TX 79029
Billing Address
Moore County Hospital District dba Memorial Hospital
224 E. 2nd St.
Dumas, TX 79029
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 4/1/2018, terminated 10/1/2018. Reinstated 4/1/2019.
01/25/2019
April 2025
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