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CAH141300-04 THOMAS H BOYD CRITICAL ACC HOSPITAL (Active)
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Main Details
Name
THOMAS H BOYD CRITICAL ACC HOSPITAL
Subdivision Name
Thomas H. Boyd Rural Health Clinic - Primary Care
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141300-04
Medicare Provider Number
141300
Outpatient Facility Provider Number
143475
Additional Details
Current Program Status
Active
Registration Date
10/12/2018
Participating Start Date
1/1/2019
Participating Approval Date
11/21/2018
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Thomas H. Boyd Memorial Hospital
Stace D Holland, CEO
(217) 942-6946
Primary Contact
Thomas H. Boyd Memorial Hospital
Kathryn Garner, CFO
(217) 942-6946 Ext: 1303
Addresses
Street Address
803 5th Street
Carrollton, IL 62016
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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