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CAH361316-04 BUCYRUS COMMUNITY HOSPITAL (Active)
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Main Details
Name
BUCYRUS COMMUNITY HOSPITAL
Subdivision Name
Provider Based Clinic - Hill Street (PBC 124) - Physician Practice
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH361316-04
Medicare Provider Number
361316
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/15/2020
Participating Start Date
4/1/2020
Participating Approval Date
2/11/2020
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Avita Health System
Eric Draime, CFO
(419) 468-0501
Primary Contact
Avita Health System
Christina Barnes, Director of Pharmacy
(419) 468-0541
Addresses
Street Address
124 Hill Street
Bucyrus, OH 44820
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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