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CAH181322-00 CALDWELL COUNTY HOSPITAL (Active)
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Main Details
Name
CALDWELL COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH181322-00
Medicare Provider Number
181322
Additional Details
Current Program Status
Active
Registration Date
7/2/2018
Participating Start Date
10/1/2018
Participating Approval Date
7/6/2018
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Caldwell County Hospital, Inc.
Harold Daniel Odegaard, CEO
(270) 365-0321
Primary Contact
Caldwell County Hospital, Inc.
Ryan Perry, Pharmacy Manager
(270) 365-0477
Addresses
Street Address
100 MEDICAL CENTER DRIVE
PRINCETON, KY 42445
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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