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CAH161361-02 Hamilton County Public Hospital d/b/a Van Diest Medical Center (Active)
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Main Details
Name
Hamilton County Public Hospital d/b/a Van Diest Medical Center
Subdivision Name
HAMILTON COUNTY PUBLIC HOSPITAL - primary care
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161361-02
Medicare Provider Number
161361
Outpatient Facility Provider Number
168591
Additional Details
Current Program Status
Active
Registration Date
7/11/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/23/2019
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Hamilton County Public Hospital
Ashley Nicole Allers, CFO
(515) 832-7705
Primary Contact
Van Diest Medical Center
Jordan Wagner, Director of Pharmacy
(515) 832-7744
Addresses
Street Address
817 SHAKESPEARE AVE
STRATFORD, IA 50249-7774
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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