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CAH141323-02 MASSAC COUNTY HOSPITAL DISTRICT (Active)
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Main Details
Name
MASSAC COUNTY HOSPITAL DISTRICT
Subdivision Name
Massac Memorial Bharat Patel, MD
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH141323-02
Medicare Provider Number
141323
Outpatient Facility Provider Number
148598
Additional Details
Current Program Status
Active
Registration Date
1/3/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/11/2022
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Massac Memorial Hospital
Lynn Ann Goines, CFO
(618) 524-2176 Ext: 2296
Primary Contact
Massac County Hospital District
LAUREN SCOTT, PHARMACY MANAGER
(618) 524-2176 Ext: 2350
Addresses
Street Address
1204 W 10th St.
C
Metropolis, IL 62960
Billing Address
Massac County Hospital District
PO Box 850
Metropolis, IL 62960
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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