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CAH161367-06 PELLA REGIONAL HEALTH CENTER (Active)
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Main Details
Name
PELLA REGIONAL HEALTH CENTER
Subdivision Name
PELLA REGIONAL HEALTH CENTER - PRAIRIE CITY MEDICAL CLINIC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH161367-06
Medicare Provider Number
161367
Outpatient Facility Provider Number
168660
Additional Details
Current Program Status
Active
Registration Date
7/12/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/19/2023
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Pella Regional Health Center
Jody VanVeen, Chief Nursing and Chief Ancillary Officer
(641) 628-6629
Primary Contact
Pella Regional Health Center
Jessica Ann Rosenhamer, Pharmacy Director
(641) 628-6616
Addresses
Street Address
404 E 2ND ST
PRAIRIE CITY MEDICAL CLINIC
PRAIRIE CITY, IA 50228-8829
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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