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CAH141331-02 MARSHALL BROWNING HOSPITAL ASSOCIATION (Terminated)
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Main Details
Name
MARSHALL BROWNING HOSPITAL ASSOCIATION
Subdivision Name
Marshall Browning Family Health Center - Primary Care
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141331-02
Medicare Provider Number
141331
Outpatient Facility Provider Number
148597
Additional Details
Current Program Status
Terminated
Registration Date
10/1/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/2/2019
Last Recertification Date
8/21/2023
Termination Date
Termination Reason
10/1/2024
Site closure
Contacts
Authorizing Official
Marshall Browning Hospital Association
Harold Calderon, CFO
(618) 542-2146 Ext: 1420
Primary Contact
Marshall Browning Hospital
Tracy Lynn Schubert, Ancillary Informatics Specialist
(618) 542-1036
Addresses
Street Address
20 NORTH WASHINGTON STREET
DU QUOIN, IL 62832
Billing Address
MARSHALL BROWNING HOSPITAL ASSOCATION
900 NORTH WASHINGTON STREET
DU QUOIN, IL 62832
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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