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CAH031301-02 BENSON HOSPITAL (Active)
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Main Details
Name
BENSON HOSPITAL
Subdivision Name
San Pedro Clinic - Primary Care - San Pedro Clinic - Primary Care
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH031301-02
Medicare Provider Number
031301
Outpatient Facility Provider Number
038516
Additional Details
Current Program Status
Active
Registration Date
10/4/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/7/2022
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Benson Hospital
Gary Kartchner, CEO
(520) 720-6606
Primary Contact
Benson Hospital
Bret Hicks, CFO
(520) 720-6508
Addresses
Street Address
890 W 4th St
Benson, AZ 85602
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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