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CAH451343-02 ELECTRA MEMORIAL HOSPITAL (Active)
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Main Details
Name
ELECTRA MEMORIAL HOSPITAL
Subdivision Name
Electra Hospital District - Park Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH451343-02
Medicare Provider Number
451343
Outpatient Facility Provider Number
673477
Additional Details
Current Program Status
Active
Registration Date
4/15/2020
Participating Start Date
5/13/2020
Participating Approval Date
4/15/2020
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Electra Memorial Hospital
REBECCA MCCAIN, CEO/ADMINISTRATOR
(940) 495-3981
Primary Contact
Electra Memorial Hospital
David Jason Lee, Pharmacist
(940) 495-3981
Addresses
Street Address
310 W Alameda St
Iowa Park, TX 76367
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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