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CAH521322-02 GRANT REGIONAL HEALTH CENTER INC. (Active)
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Main Details
Name
GRANT REGIONAL HEALTH CENTER INC.
Subdivision Name
POTOSI TENNYSON MEDICAL CLINIC - Potosi RHC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521322-02
Medicare Provider Number
521322
Outpatient Facility Provider Number
528628
Additional Details
Current Program Status
Active
Registration Date
7/14/2022
Participating Start Date
10/1/2022
Participating Approval Date
7/25/2022
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Grant Regional Health Center
Joel Gehling, CFO
(608) 723-3202
Primary Contact
Grant Regional Health Center
Erin W Hornung, Pharmacist
(608) 723-3235
Addresses
Street Address
114 US HIGHWAY 61 N
POTOSI, WI 53820-9502
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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