| Details | Last Recertification Date | Update | Recertification | 2/9/2024 2:18:39 PM | 2/28/2025 4:57:36 PM | 2/28/2025 4:57 PM |
| Addresses | Billing Address | Insert | Recertification | | Ocoee Regional Health Corp
PO Box 308
Benton, TN 37307 | 2/9/2024 2:18 PM |
| Details | Last Recertification Date | Update | Recertification | 2/7/2023 2:34:25 PM | 2/9/2024 2:18:39 PM | 2/9/2024 2:18 PM |
| Details | Last Recertification Date | Update | Recertification | 2/16/2022 8:57:14 AM | 2/7/2023 2:34:25 PM | 2/7/2023 2:34 PM |
| Details | Last Recertification Date | Update | Recertification | 2/4/2021 11:20:05 AM | 2/16/2022 8:57:14 AM | 2/16/2022 8:57 AM |
| Contacts | Primary Contact | Update | Change Request | Miller, Stephen
CFO
Ocoee Regional Health Corporation
4233388995 | Blakely, Chandler Lauren
Chief Financial Officer
Ocoee Regional Health Corporation
4233388995-1205 | 3/15/2021 10:20 AM |
| Details | Last Recertification Date | Update | Recertification | 1/27/2020 4:01:34 PM | 2/4/2021 11:20:05 AM | 2/4/2021 11:20 AM |
| Details | Last Recertification Date | Update | Recertification | 2/13/2019 2:25:36 PM | 1/27/2020 4:01:34 PM | 1/27/2020 4:01 PM |
| Contacts | Primary Contact | Update | Change Request | Waters, Mike
COO
Ocoee Regional Health Corporation
4233388995-1211 | Miller, Stephen
CFO
Ocoee Regional Health Corporation
4233388995 | 2/28/2019 9:59 AM |
| Details | Last Recertification Date | Update | Recertification | 3/1/2018 8:30:18 AM | 2/13/2019 2:25:36 PM | 2/13/2019 2:25 PM |
| Contacts | Primary Contact | Update | Recertification | MOATS, BILL
CEO
Ocoee Regional Health Corp.
4233388995-1212 | Waters, Mike
COO
Ocoee Regional Health Corporation
4233388995-1211 | 3/1/2018 8:30 AM |
| Details | Last Recertification Date | Update | Recertification | 2/15/2017 12:00:00 AM | 3/1/2018 8:30:18 AM | 3/1/2018 8:30 AM |
| Contacts | Authorizing Official | Update | | MOATS, BILL
CEO
4233388995-1212 | MOATS, BILL
CEO
Ocoee Regional Health Corp.
4233388995-1212 | 10/6/2017 4:30 PM |
| Contacts | Primary Contact | Update | | MOATS, BILL
CEO
4233388995-1212 | MOATS, BILL
CEO
Ocoee Regional Health Corp.
4233388995-1212 | 10/6/2017 4:30 PM |
| Addresses | Main Address | Insert | | |
10120 SR 56
Coalmont, TN 37313-2505 | 2/15/2017 9:51 AM |
| Contacts | Authorizing Official | Insert | | | MOATS, BILL
CEO
4233388995-1212 | 2/15/2017 9:51 AM |
| Contacts | Primary Contact | Update | | SMITH, BRIAN
CFO
4233388995 | MOATS, BILL
CEO
4233388995-1212 | 2/15/2017 9:51 AM |
| Details | Last Recertification Date | Update | | 3/2/2016 12:00:00 AM | 2/15/2017 12:00:00 AM | 2/15/2017 9:51 AM |
| Details | Last Recertification Date | Update | | | 3/2/2016 12:00:00 AM | 3/2/2016 9:29 AM |
| Details | Last Recertification Date | Update | | 4/1/2013 12:00:00 AM | | 6/2/2015 10:47 AM |
| Details | State | Update | | Terminated | Active | 6/2/2015 10:47 AM |
| Dates | Start Date | Update | | 4/1/2005 12:00:00 AM | 7/1/2015 12:00:00 AM | 6/2/2015 10:47 AM |
| Terminations | Termination Date | Update | | 4/1/2013 12:00:00 AM | | 6/2/2015 10:47 AM |
| Terminations | Termination Reason | Update | | Other | | 6/2/2015 10:47 AM |
| Details | Comments Public | Insert | | | 5/26/15 participating 4/1/05 thru 3/31/13, not participating 4/1/13 thru 6/30/15 due to business decision, reinstated based on on-line registration submitted in April 2015 | 5/26/2015 11:02 AM |
| Contacts | Primary Contact | Insert | | | SMITH, BRIAN
CFO
4233388995 | 3/11/2013 8:22 AM |
| Details | Last Recertification Date | Update | | | 4/1/2013 12:00:00 AM | 3/11/2013 8:21 AM |
| Details | State | Update | | Active | Terminated | 3/11/2013 8:21 AM |
| Terminations | Termination Date | Update | | | 4/1/2013 12:00:00 AM | 3/11/2013 8:21 AM |
| Terminations | Termination Reason | Update | | | Other | 3/11/2013 8:21 AM |
| Details | Last Recertification Date | Insert | | | | 8/12/2005 9:13 AM |
| Details | Grant Number | Insert | | | H80CS00762 | 8/12/2005 9:13 AM |
| Details | 340B ID | Insert | | | CH04123D | 8/12/2005 9:13 AM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 8/12/2005 9:13 AM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 8/12/2005 9:13 AM |
| Details | Medicare Provider Number | Insert | | | | 8/12/2005 9:13 AM |
| Details | Entity Name | Insert | | | OCOEE REGIONAL HEALTH CORPORATION | 8/12/2005 9:13 AM |
| Details | Program Code | Insert | | | CH | 8/12/2005 9:13 AM |
| Details | Entity Subname | Insert | | | GRUNDY COUNTY PRIMARY CARE CENTER | 8/12/2005 9:13 AM |
| Dates | Participating Approval Date | Insert | | | 3/1/2005 12:00:00 AM | 8/12/2005 9:13 AM |
| Details | State | Insert | | | Active | 8/12/2005 9:13 AM |
| Dates | Registration Date | Insert | | | 4/1/2005 12:00:00 AM | 8/12/2005 9:13 AM |
| Dates | Signed By Date | Insert | | | | 8/12/2005 9:13 AM |
| Dates | Start Date | Insert | | | 4/1/2005 12:00:00 AM | 8/12/2005 9:13 AM |
| Terminations | Termination Comments | Insert | | | | 8/12/2005 9:13 AM |
| Terminations | Termination Date | Insert | | | | 8/12/2005 9:13 AM |
| Terminations | Termination Effective Date | Insert | | | | 8/12/2005 9:13 AM |
| Terminations | Termination Reason | Insert | | | | 8/12/2005 9:13 AM |
| Details | Comments Public | Insert | | | NEW SITE 4/1/05 | 8/12/2005 9:13 AM |