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CAH521356-14 Oconto Hospital & Medical Center, Inc. dba Bellin Health Oconto Hospital (Active)
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Main Details
Name
Oconto Hospital & Medical Center, Inc. dba Bellin Health Oconto Hospital
Subdivision Name
OCONTO HOSPITAL & MEDICAL CENTER IN - Bellin Health Lakewood, a department of Bellin Health Oconto Hospital
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH521356-14
Medicare Provider Number
521356
Outpatient Facility Provider Number
528630
Additional Details
Current Program Status
Active
Registration Date
7/17/2023
Participating Start Date
10/1/2023
Participating Approval Date
7/20/2023
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Oconto Hospital & Medical Center, Inc.dba Bellin Health Oconto Hospital
Julie Ann Bulin, Vice President
(920) 835-2932
Primary Contact
Oconto Hospital & Medical Center Inc dba Bellin Health Oconto Hospital
Jason E Knox, Pharmacist
(715) 735-2213
Addresses
Street Address
15481 COMMERCIAL RD
LAKEWOOD, WI 54138-9677
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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