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CAH151304-12 RUSH MEMORIAL HOSPITAL (Active)
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Main Details
Name
RUSH MEMORIAL HOSPITAL
Subdivision Name
RUSH MEMORIAL HOSPITAL - RMH Multi-Specialty
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH151304-12
Medicare Provider Number
151304
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/5/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/18/2021
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Rush Memorial Hospital
BRADLEY SMITH, CEO
(765) 932-7513
Primary Contact
Rush Memorial Hospital
Greg Pratt, Director of Pharmacy
(765) 932-7497
Addresses
Street Address
110 EAST 13TH STREET
RUSHVILLE, IN 46173-2126
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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