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CH07402A CROSS TRAILS MEDICAL CENTER (Active)
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Main Details
Name
CROSS TRAILS MEDICAL CENTER
Subdivision Name
Type
HRSA-Funded Health Center
Site ID
BPS-H80-001379
340B ID
CH07402A
Grant Number
H80CS00211
Additional Details
Current Program Status
Active
Registration Date
10/1/1998
Participating Start Date
10/1/1998
Participating Approval Date
6/24/2004
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Cross Trails Medical Center
Amy D Lanzotti, CFO
(573) 339-1196
Primary Contact
Crosstrails Medical Center
Richard Francis, CEO
(573) 339-1196
Addresses
Street Address
109 HIGHWAY 51 NORTH
MARBLE HILL, MO 63764
Billing Address
CROSS TRAILS MEDICAL CENTER - ADMINISTRATIVE OFFICE
408 S. BROADVIEW STREET
CAPE GIRARDEAU, MO 63703
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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NEW BILL TO ADDRESS
11/02/2005
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