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CAH371334-00 CARNEGIE TRI-COUNTY MUNICIPAL HOSPIT (Active)
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Main Details
Name
CARNEGIE TRI-COUNTY MUNICIPAL HOSPIT
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH371334-00
Medicare Provider Number
371334
Additional Details
Current Program Status
Active
Registration Date
10/14/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/30/2019
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Carnegie Tri-County Municipal Hospital
Nathan Adam Richmond, Hospital Administrator
(580) 654-1050 Ext: 2307
Primary Contact
Cohesive Healthcare Management & Consulting
Miranda Walz-Allen, Project Manager
(620) 213-2125
Addresses
Street Address
102 N BROADWAY
CARNEGIE, OK 73015
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2018, terminated 10/1/2019. Reinstated 1/1/2020.
10/30/2019
April 2025
April 2025
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