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SCH140001-30 GRAHAM HOSPITAL ASSOCIATION (Active)
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Main Details
Name
GRAHAM HOSPITAL ASSOCIATION
Subdivision Name
GRAHAM HOSPITAL ASSOCIATION - GRAHAM MEDICAL GROUP - WILLIAMSFIELD - Family Practice
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH140001-30
Medicare Provider Number
140001
Outpatient Facility Provider Number
148636
Additional Details
Current Program Status
Active
Registration Date
1/2/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/5/2024
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Graham Hospital Association
Holly Henline, VP of Ancillary Services & Corporate Compliance Officer
(309) 647-5240 Ext: 2709
Primary Contact
Graham Hospital Association
Corie Christian, Compliance/340B Director
(309) 647-5240 Ext: 2414
Addresses
Street Address
120 E. Gale Street
Williamsfield, IL 61489-5418
Billing Address
Graham Medical Group
180 S. Main Street
Canton, IL 61520
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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