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CAH521323-03 Memorial Medical Center (Active)
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Main Details
Name
Memorial Medical Center
Subdivision Name
MCHS-Colby - Colby-Abbotsford Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521323-03
Medicare Provider Number
521323
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/4/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/4/2022
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
MCHS-Neillsville
Sally Zillman, Chief Administrative Officer, MMC - Neillsville
(715) 819-8227
Primary Contact
Marshfield Clinic Health System
Girish Kaimal, Chief Pharmacy Officer
(623) 296-2075
Addresses
Street Address
111 E. Dehne Drive
Colby, WI 54421
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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