340B Drug Pricing Program Database
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CAH371335-00 Haskell Regional Hospital, Inc (Active)
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Main Details
Name
Haskell Regional Hospital, Inc
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH371335-00
Medicare Provider Number
371335
Additional Details
Current Program Status
Active
Registration Date
1/14/2021
Participating Start Date
4/1/2021
Participating Approval Date
2/19/2021
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Haskell Regional Hospital
Naji Al-Saeed, Administrator
(507) 272-2769
Primary Contact
Boa Vida Healthcare
Lisa Tang, 340B Program Director
(317) 324-1466
Addresses
Street Address
401 NW H STREET
STIGLER, OK 74462
Billing Address
Haskell Regional Hospital, INC
10996 Four Seasons Place
100C
Crown Point, IN 46307-7762
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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