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CAH371334-01 CARNEGIE TRI-COUNTY MUNICIPAL HOSPIT (Active)
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Main Details
Name
CARNEGIE TRI-COUNTY MUNICIPAL HOSPIT
Subdivision Name
CARNEGIE TRI-COUNTY MUNICIPAL HOSPI - Carnegie Medical Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH371334-01
Medicare Provider Number
371334
Outpatient Facility Provider Number
378542
Additional Details
Current Program Status
Active
Registration Date
1/5/2022
Participating Start Date
4/1/2022
Participating Approval Date
1/6/2022
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Carnegie Tri-County Municipal Hospital
Nathan Adam Richmond, Hospital Administrator
(580) 654-1050 Ext: 2307
Primary Contact
Cohesive Healthcare Management & Consulting
Miranda Walz-Allen, Project Manager
(620) 213-2125
Addresses
Street Address
101 W ASH ST
CARNEGIE MEDICAL CLINIC
CARNEGIE, OK 73015-5013
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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