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CAH171380-03 NEOSHO MEMORIAL REGIONAL MED CTR (Active)
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Main Details
Name
NEOSHO MEMORIAL REGIONAL MED CTR
Subdivision Name
NMRMC Family Medicine Clinic - NMRMC Family Medicine Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH171380-03
Medicare Provider Number
171380
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/18/2019
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Neosho Memorial regional Medical Center
Wendy Brazil, COO
(620) 432-5310
Primary Contact
Neosho Memorial Regional Medical Center
Katlyn Aikins, Pharmacy Director
(620) 432-5344
Addresses
Street Address
1501 W 7th Street
Chanute, KS 66720
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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