340B Drug Pricing Program Database


DSH180009C KING'S DAUGHTERS MEDICAL CENTER (Active) - information as of 4/25/2025 5:38:52 PM

Main Details
KING'S DAUGHTERS MEDICAL CENTER
FLATWOODS FAMILY CARE CENTER
Disproportionate Share Hospital
No
DSH180009C
180009


Additional Details
Active
11/9/2011
1/1/2012
12/14/2011
8/22/2024

Contacts

King's Daughters Medical Center
Sara Marks, Interim CEO
(606) 408-4401

King's Daughters Medical Center
Debbie Bell, 340B Coordinator
(606) 408-9503

Addresses

1107 Bellefonte Road
Flatwoods, KY 41139

Kings Daughters Medical Center
Po Box 151
Ashland, KY 41105-0151


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
OH47105031851346720
KY010128711851346720
WV00016660001851346720
Shipping Addresses

Same as Street Address
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
DSH180009AChildDSHKING'S DAUGHTERS MEDICAL CENTERSOUTH POINT PRIMARY CARE214 COLLINS AVE, SUITE ASouth PointOHActive
DSH180009AAChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS NEUROLOGY - NEUROLOGY617 23RD STREETASHLANDKYActive
DSH180009ABChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS PULMONARY - PULMONARY613 23RD STREETASHLANDKYActive
DSH180009ACChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS GASTROENTEROLOGY - GASTROENTEROLOGY613 23RD STREETASHLANDKYActive
DSH180009ADChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC ASHLAND PEDS - PEDIATRICS2301 LEXINGTON AVEASHLANDKYActive
DSH180009AEChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS ORTHOPEDICS & SPORTS MEDICINE RUSSELL398 DIEDERICH BLVDRUSSELLKYActive
DSH180009AFChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS CARDIOLOGY - CARDIOLOGY613 23RD STREETASHLANDKYActive
DSH180009AGChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC CENTRAL AVENUE PRIMARY CARE - PRIMARY CARE1200 CENTRAL AVENUEASHLANDKYTerminated
DSH180009AHChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS CARDIOLOGY - CARDIOLOGY2001 SCIOTO TRAILPORTSMOUTHOHTerminated
DSH180009AJChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS CARDIOTHORACIC SURGEONS OF KY - CARDIOTHORACIC SURGERY613 23RD STREETASHLANDKYActive
DSH180009AKChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS RHEUMATOLOGY - RHEUMATOLOGY617 23RD STREETASHLANDKYActive
DSH180009ALChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS DETHERAGE FAMILY CARE - FAMILY CARE617 23RD STREETASHLANDKYActive
DSH180009AMChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS ENT ASSOCIATES OF ASHLAND - OTOLARYNGOLOGY613 23RD STREETASHLANDKYActive
DSH180009ANChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS NEPHROLOGY - NEPHROLOGY613 23RD STREETASHLANDKYActive
DSH180009APChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS NEUROSURGICAL SPECS - NEUROLOGY617 23RD STREETASHLANDKYActive
DSH180009AQChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS ORTHOPEDICS - ORTHOPEDICS613 23RD STREETASHLANDKYActive
DSH180009ARChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS PORTSMOUTH ORTHOPEDICS - ORTHOPEDICS1729 KINNEYS LANEPORTSMOUTHOHActive
DSH180009ASChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS SURGERY SUITE II - SURGERY613 23RD STREETASHLANDKYActive
DSH180009ATChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS PLASTIC & RECONSTRUCTIVE SURGERY617 23RD STREETASHLANDKYActive
DSH180009AUChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS CARDIOLOGY & VASCULAR SURGERY1729 KINNEYS LANEPORTSMOUTHOHActive
DSH180009AVChildDSHKING'S DAUGHTERS MEDICAL CENTERRUSSELL URGENT CARE CENTER398 DIEDERICH BLVDRUSSELLKYActive
DSH180009AWChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS UROLOGY PORTSMOUTH - UROLOGY1729 KINNEYS LANEPORTSMOUTHOHActive
DSH180009AXChildDSHKING'S DAUGHTERS MEDICAL CENTEROUTPATIENT BEHAVIORAL MEDICINE - BEHAVIORAL MEDICINE1061 KENWOOD DRRUSSELLKYActive
DSH180009AYChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS CORNERSTONE PRIMARY - CORNERSTONE PRIMARY CARE1816 CARTER AVEASHLANDKYActive
DSH180009AZChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC GREENUP PRIMARY CARE - PRIMARY CARE1629 ASHLAND RDGREENUPKYActive
DSH180009BChildDSHKING'S DAUGHTERS MEDICAL CENTEROLIVE HILL FAMILY CARE CENTER391 W Tom T Hall BlvdOlive HillKYActive
DSH180009BAChildDSHKING'S DAUGHTERS MEDICAL CENTERASHLAND HOSPITAL CORPORATION - ASHLAND CARTER AVE PEDIATRICS2910 CARTER AVEASHLANDKYActive
DSH180009BBChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - RUSSELL MEDICAL SPECIALTIES1000 ASHLAND DRASHLANDKYActive
DSH180009BCChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - RUSSELL CARDIOLOGY1180 SAINT CHRISTOPHER DRASHLANDKYActive
DSH180009BDChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - WOMEN'S CARE2001 WINCHESTER AVEASHLANDKYActive
DSH180009BEChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDIAL CENTER - INFECTIOUS DISEASE613 23RD STASHLANDKYActive
DSH180009BFChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC ASHLAND PRIMARY CARE - PRIMARY CARE2028 WINCHESTER AVEASHLANDKYActive
DSH180009BGChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - CANNONSBURG URGENT CARE CENTER12470 US 60ASHLANDKYActive
DSH180009BHChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - RUSSELL PODIATRY1000 ASHLAND DRASHLANDKYActive
DSH180009BJChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC PRIMARY CARE AND PEDS BELLE - PRIMARY CARE AND PEDIATRICS1000 ASHLAND DRASHLANDKYActive
DSH180009BKChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC FLATWOODS PRIMARY CARE - PRIMARY CARE2420 ARGILLITE RDFLATWOODSKYActive
DSH180009BLChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - BELLEFONTE HEART FAILURE CLINIC1180 SAINT CHRISTOPHER DRASHLANDKYActive
DSH180009BMChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - DERMATOLOGY1200 CENTRAL AVEASHLANDKYActive
DSH180009BNChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC PRIMARY CARE - CANNONSBURG PRIMARY CARE12470 US 60ASHLANDKYActive
DSH180009BPChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - BELLEFONTE CARDIOLOGY800 SAINT CHRISTOPHER DRASHLANDKYActive
DSH180009BQChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC ASHLAND FAMILY MEDICINE - FAMILY MEDICINE2340 CARTER AVEASHLANDKYActive
DSH180009BRChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC PORTSMOUTH INTERNAL MEDICINE - KDMC PORTSMOUTH INTERNAL MEDICINE2001 SCIOTO TRLPORTSMOUTHOHTerminated
DSH180009BSChildDSHKING'S DAUGHTERS MEDICAL CENTERKD HENRY ADKINS PRIMARY CARE - KD HENRY ADKINS PRIMARY CARE105 STATE HIGHWAY 1947, SUITE BGRAYSONKYActive
DSH180009BTChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC CARTER COUNTY PRIMARY CARE - KDMC CARTER COUNTY PRIMARY CARE105 STATE HIGHWAY 1947GRAYSONKYActive
DSH180009BUChildDSHKING'S DAUGHTERS MEDICAL CENTERKING'S DAUGHTERS STRUCTURAL HEART - KING'S DAUGHTERS STRUCTURAL HEART617 23RD ST SUITE 103ASHLANDKYActive
DSH180009BVChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL SPECIALTIES - KINGS DAUGHTERS MEDICAL SPECIALTIES1729 KINNEYS LANE SUITE 201PORTSMOUTHOHActive
DSH180009BWChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS PORTSMOUTH GASTROENTEROLOGY - KDMS PORTSMOUTH GASTROENTEROLOGY1729 KINNEYS LANE SUITE 203PORTSMOUTHOHActive
DSH180009BXChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - LOUISA MEDICAL SPECIALTIES2145 KY 2565LOUISAKYActive
DSH180009BYChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - PAINTSVILLE PRIMARY CARE354 N MAYO TRLPAINTSVILLEKYActive
DSH180009BZChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMC - CENTER FOR HEALTHY LIVING/SURGICAL WEIGHT LOSS1200 CENTRAL AVEASHLANDKYActive
DSH180009CChildDSHKING'S DAUGHTERS MEDICAL CENTERFLATWOODS FAMILY CARE CENTER1107 Bellefonte RoadFlatwoodsKYActive
DSH180009CAChildDSHKING'S DAUGHTERS MEDICAL CENTERASHLAND HOSPITAL CORPORATION - IRONTON PEDIATRICS912 PARK AVEIRONTONOHActive
DSH180009CBChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - ASHLAND CENTER FOR WOMEN'S HEALTH617 23RD STASHLANDKYActive
DSH180009CCChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - BLUEGRASS UROLOGY336 29TH STASHLANDKYActive
DSH180009CDChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - PORTSMOUTH OUTPATIENT BEHAVIORAL MEDICINE1729 KINNEYS LNPORTSMOUTHOHActive
DSH180009CEChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - PAINTSVILLE MEDICAL SPECIALTIES354 NORTH MAYO TRAILPAINTSVILLEKYActive
DSH180009CFChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - PAINTSVILLE URGENT CARE CENTER354 NORTH MAYO TRAILPAINTSVILLEKYActive
DSH180009CGChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - PRESTONSBURG FAMILY CARE CENTER1279 OLD ABBOTT MOUNTAIN RDPRESTONSBURGKYActive
DSH180009CHChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - PRESTONSBURG MEDICAL SPECIALTIES1279 OLD ABBOTT MOUNTAIN RDPRESTONSBURGKYActive
DSH180009CJChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - ASHLAND PODIATRY336 29TH STASHLANDKYActive
DSH180009CKChildDSHKING'S DAUGHTERS MEDICAL CENTERKINGS DAUGHTERS MEDICAL CENTER - REGIONAL ENDOCRINOLOGY613 23RD STASHLANDKYActive
DSH180009DChildDSHKING'S DAUGHTERS MEDICAL CENTERIRONTON FAMILY CARE CENTER912 Park AveIrontonOHActive
DSH180009EChildDSHKING'S DAUGHTERS MEDICAL CENTERFLATWOODS MEDICAL SPECIALTIES1109 Bellefonte RoadFlatwoodsKYActive
DSH180009FChildDSHKING'S DAUGHTERS MEDICAL CENTERPORTSMOUTH FAMILY CARE CENTER2001 Scioto TrailPortsmouthOHTerminated
DSH180009GChildDSHKING'S DAUGHTERS MEDICAL CENTERGRAYSON FAMILY CARE CENTER100 BELLEFONTE DRIVEGraysonKYActive
DSH180009HChildDSHKING'S DAUGHTERS MEDICAL CENTERCATLETTSBURG FAMILY CARE CENTER10015 US 23CatlettsburgKYActive
DSH180009JChildDSHKING'S DAUGHTERS MEDICAL CENTERCEDAR KNOLL FAMILY CARE CENTER10650 US RT 60AshlandKYActive
DSH180009KChildDSHKING'S DAUGHTERS MEDICAL CENTERCEDAR KNOLL PEDIATRICS10650 US RT 60AshlandKYActive
DSH180009LChildDSHKING'S DAUGHTERS MEDICAL CENTERASHLAND URGENT CARE CENTER2245 Winchester AveAshlandKYActive
DSH180009MChildDSHKING'S DAUGHTERS MEDICAL CENTERGRAYSON URGENT CARE CENTER609 NORTH CAROL MALONE BLVDGraysonKYActive
DSH180009PChildDSHKING'S DAUGHTERS MEDICAL CENTERIRONTON URGENT CARE CENTER912 Park AveIrontonOHActive
DSH180009QChildDSHKING'S DAUGHTERS MEDICAL CENTERWHEELERSBURG FAMILY CARE CENTER8750 Ohio River RoadWheelersburgOHActive
DSH180009RChildDSHKING'S DAUGHTERS MEDICAL CENTERPortsmouth Oncology916 11th StreetPortsmouthOHActive
DSH180009SChildDSHKING'S DAUGHTERS MEDICAL CENTERTri State Hematology/Oncology617 23rd Street #19AshlandKYActive
DSH180009TChildDSHKING'S DAUGHTERS MEDICAL CENTERPAIN AND SPINE CARE617 23RD ST SUITE 8BASHLANDKYActive
DSH180009UChildDSHKING'S DAUGHTERS MEDICAL CENTERBURLINGTON URGENT CARE CENTER384 COUNTY RD 120 SOSOUTH POINTOHActive
DSH180009VChildDSHKING'S DAUGHTERS MEDICAL CENTERWOUND CARE617 23RD ST SUITE 215ASHLANDKYActive
DSH180009WChildDSHKING'S DAUGHTERS MEDICAL CENTERHOME HEALTH2025 Carter AvenueAshlandKYTerminated
DSH180009XChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS ENDOCRINOLOGY - ENDOCRINOLOGY1200 CENTRAL AVENUEASHLANDKYActive
DSH180009YChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS TRI-STATE VASCULAR SPECIALISTS - VASCULAR SURGERY609 N CAROL MALONE BLVDGRAYSONKYActive
DSH180009ZChildDSHKING'S DAUGHTERS MEDICAL CENTERKDMS GYNECOLOGY - GYNECOLOGY2245 WINCHESTER AVENUEASHLANDKYActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification8/21/2023 9:09:43 AM8/22/2024 8:21:14 AM8/22/2024 8:21 AM
DetailsLast Recertification DateUpdateRecertification8/24/2022 1:59:57 PM8/21/2023 9:09:43 AM8/21/2023 9:09 AM
ContactsAuthorizing OfficialUpdateChange RequestWhitlatch, Kristie CEO King's Daughters Medical Center 6064084401Marks, Sara Interim CEO King's Daughters Medical Center 60640844011/5/2023 2:55 PM
DetailsLast Recertification DateUpdateRecertification8/16/2021 10:40:27 AM8/24/2022 1:59:57 PM8/24/2022 1:59 PM
DetailsLast Recertification DateUpdateRecertification8/31/2020 1:14:03 PM8/16/2021 10:40:27 AM8/16/2021 10:40 AM
Medicaid BillingNPI: NumberInsertRecertification 18513467208/31/2020 1:14 PM
Medicaid BillingNPI: StateInsertRecertification WV8/31/2020 1:14 PM
Medicaid BillingNPI: NumberInsertRecertification 18513467208/31/2020 1:14 PM
Medicaid BillingNPI: StateInsertRecertification KY8/31/2020 1:14 PM
Medicaid BillingNPI: NumberInsertRecertification 18513467208/31/2020 1:14 PM
Medicaid BillingNPI: StateInsertRecertification OH8/31/2020 1:14 PM
Medicaid BillingNPI: NumberDeleteRecertification1851346720 ( ) 8/31/2020 1:14 PM
Medicaid BillingNPI: NumberDeleteRecertification1851346720 ( ) 8/31/2020 1:14 PM
Medicaid BillingNPI: NumberDeleteRecertification1851346720 ( ) 8/31/2020 1:14 PM
DetailsLast Recertification DateUpdateRecertification8/20/2019 12:51:50 PM8/31/2020 1:14:03 PM8/31/2020 1:14 PM
DetailsLast Recertification DateUpdateRecertification8/17/2018 8:54:56 AM8/20/2019 12:51:50 PM8/20/2019 12:51 PM
DetailsLast Recertification DateUpdateRecertification11/28/2017 10:38:25 AM8/17/2018 8:54:56 AM8/17/2018 8:54 AM
DetailsLast Recertification DateUpdateRecertification8/10/2016 12:00:00 AM11/28/2017 10:38:25 AM11/28/2017 10:38 AM
ContactsAuthorizing OfficialUpdate Whitlatch, Kristie CEO 6064084401Whitlatch, Kristie CEO King's Daughters Medical Center 606408440110/18/2017 3:27 PM
ContactsPrimary ContactUpdate Bell, Debbie 340B Coordinator 6064089503Bell, Debbie 340B Coordinator King's Daughters Medical Center 606408950310/3/2017 11:50 AM
ContactsAuthorizing OfficialInsert  Whitlatch, Kristie CEO 60640844017/13/2017 10:19 AM
ContactsSigned ByInsert  McDowell, Paul CFO 60640844046/15/2017 11:51 AM
ContactsPrimary ContactUpdate Layne, David Business Development Director 6064089500Bell, Debbie 340B Coordinator 60640895036/15/2017 11:51 AM
AddressesMain AddressInsert   1107 Bellefonte Road Flatwoods, KY 411396/13/2017 4:55 PM
AddressesBilling AddressInsert  Kings Daughters Medical Center Po Box 151 Ashland, KY 41105-01516/13/2017 4:55 PM
DetailsLast Recertification DateUpdate 8/12/2015 12:00:00 AM8/10/2016 12:00:00 AM8/10/2016 5:43 PM
Medicaid BillingMedicaid: NumberUpdate 000166600100016660002/17/2016 3:57 PM
Medicaid BillingNPI: NumberUpdate 137659099218513467202/17/2016 3:57 PM
ContactsPrimary ContactInsert  Layne, David Business Development Director 60640895008/12/2015 9:46 AM
DetailsLast Recertification DateUpdate 9/9/2014 12:00:00 AM8/12/2015 12:00:00 AM8/12/2015 9:46 AM
Medicaid BillingMedicaid: Is PrimaryInsert  False5/28/2015 4:43 PM
Medicaid BillingMedicaid: NumberInsert  00016660015/28/2015 4:43 PM
Medicaid BillingMedicaid: StateInsert  WV5/28/2015 4:43 PM
Medicaid BillingNPI: NumberInsert  18513467205/28/2015 4:43 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False9/9/2014 3:48 PM
Medicaid BillingMedicaid: NumberInsert  47105039/9/2014 3:48 PM
Medicaid BillingMedicaid: StateInsert  OH9/9/2014 3:48 PM
Medicaid BillingMedicaid: Is PrimaryInsert  False9/9/2014 3:48 PM
Medicaid BillingMedicaid: NumberInsert  010128719/9/2014 3:48 PM
Medicaid BillingMedicaid: StateInsert  KY9/9/2014 3:48 PM
Medicaid BillingNPI: NumberInsert  18513467209/9/2014 3:48 PM
Medicaid BillingNPI: NumberInsert  13765909929/9/2014 3:48 PM
DetailsLast Recertification DateUpdate 8/28/2013 12:00:00 AM9/9/2014 12:00:00 AM9/9/2014 3:48 PM
DetailsLast Recertification DateUpdate  8/28/2013 12:00:00 AM8/28/2013 12:44 PM
DatesParticipating Approval DateUpdate  12/14/2011 12:00:00 AM12/14/2011 12:56 PM
DetailsStateUpdate PendingActive12/14/2011 12:56 PM
DatesStart DateUpdate  1/1/2012 12:00:00 AM12/14/2011 12:56 PM
DatesParticipating Approval DateUpdate 12/14/2011 12:00:00 AM 12/1/2011 4:03 PM
DetailsStateUpdate ActivePending12/1/2011 4:03 PM
DatesStart DateUpdate 1/1/2012 12:00:00 AM 12/1/2011 4:03 PM
DetailsLast Recertification DateInsert   1/1/1900 12:00 AM
DetailsGrant NumberInsert   1/1/1900 12:00 AM
Details340B IDInsert  DSH180009C1/1/1900 12:00 AM
DetailsIs Authorizing Official EHB DataInsert   1/1/1900 12:00 AM
DatesLast Date That 340B Drugs PurchasedInsert   1/1/1900 12:00 AM
DetailsMedicare Provider NumberInsert  1800091/1/1900 12:00 AM
DetailsEntity NameInsert  KING'S DAUGHTERS MEDICAL CENTER1/1/1900 12:00 AM
DetailsProgram CodeInsert  DSH1/1/1900 12:00 AM
DetailsEntity SubnameInsert  FLATWOODS FAMILY CARE CENTER1/1/1900 12:00 AM
DatesParticipating Approval DateInsert  12/14/2011 12:00:00 AM1/1/1900 12:00 AM
DetailsStateInsert  Active1/1/1900 12:00 AM
DatesRegistration DateInsert  11/9/2011 12:00:00 AM1/1/1900 12:00 AM
DatesSigned By DateInsert  11/9/2011 12:00:00 AM1/1/1900 12:00 AM
DatesStart DateInsert  1/1/2012 12:00:00 AM1/1/1900 12:00 AM
TerminationsTermination CommentsInsert   1/1/1900 12:00 AM
TerminationsTermination DateInsert   1/1/1900 12:00 AM
TerminationsTermination Effective DateInsert   1/1/1900 12:00 AM
TerminationsTermination ReasonInsert   1/1/1900 12:00 AM