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CAH291313-01 Banner Churchill Community Hospital (Active)
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Main Details
Name
Banner Churchill Community Hospital
Subdivision Name
BANNER CHURCHILL COMMUNITY HOSPITAL - Fernley HC PCP RHC - Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH291313-01
Medicare Provider Number
291313
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/11/2019
Participating Start Date
1/1/2020
Participating Approval Date
11/7/2019
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Banner Payson Medical Center
Matthew K King, Senior Finance Director
(801) 682-9661
Primary Contact
Banner Churchill Community Hospital
Alison S. Toigo, Associate Director of Pharmacy
(775) 867-7123
Addresses
Street Address
1260 NEVADA PACIFIC BLVD
FERNLEY, NV 89408-9871
Billing Address
Banner Health Accounts Payable
PO Box 2977
Phoenix, AZ 85062
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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