Covered Entity Details

DSH250040H SINGING RIVER HEALTH SYSTEM (Terminated) - information as of 4/30/2025 10:53:57 PM

Main Details

Name

SINGING RIVER HEALTH SYSTEM

Subdivision Name

Singing River Medical Clinic-Ocean Springs

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH250040H

Medicare Provider Number

250040

Outpatient Facility Provider Number

250040

Additional Details

Current Program Status

Terminated

Registration Date

12/29/2011

Participating Start Date

3/15/2022

Participating Approval Date

3/27/2012

Last Recertification Date

9/8/2023

Termination Date
Termination Reason

7/1/2024
DSH percentage below statutory minimum

Contacts

Authorizing Official

Singing River Health System
Heath Allen Thompson, Administrator Ancillary Services
(228) 818-1191

Primary Contact

Singing River Health System
Lisa D Fratesi, Executive Director of Pharmacy
(662) 347-0066

Addresses

Street Address

3099 Bienville Boulevard
Ocean Springs, MS 39564

Billing Address

Singing River Health System
3109 Bienville Blvd
Ocean Springs, MS 39564

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
AL	HOS0040P	1083893937
FL	095912000	1083893937
LA	1732524	1083893937
MS	000020059,100000111,100008396,100008406	1083893937,1124136593

Shipping Addresses

Shipping Address 1

Ocean Springs Hospital
3109 Bienville Blvd
Ocean Springs, MS 39564

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH250040A	Child	DSH	SINGING RIVER HEALTH SYSTEM	OCEAN SPRINGS HOSPITAL	3109 BIENVILLE BLVD	OCEAN SPRINGS	MS	Terminated
DSH250040AA	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Hospital / Heart Failure Clinic	3109 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AB	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Hospital / Woundcare/Hyperbarics	3109 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AC	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Hospital / Radiology Services	3109 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AD	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Hospital / Anesthesia	3109 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AE	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Hospital / Cardiac Catheterization Lab	3109 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AF	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Hospital / Emergency Department	3109 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AG	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Hospital / Respiratory Therapy	3109 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AH	Child	DSH	SINGING RIVER HEALTH SYSTEM	SRH Medical Park / Nuc Med Radiology	3101 Denny Ave	Pascagoula	MS	Terminated
DSH250040AJ	Child	DSH	SINGING RIVER HEALTH SYSTEM	Neuroscience Center	57 DEWEY ST	LUCEDALE	MS	Terminated
DSH250040AK	Child	DSH	SINGING RIVER HEALTH SYSTEM	Pulmonary Medicine / Pulmonary Services	3101 DENNY AVENUE	PASCAGOULA	MS	Terminated
DSH250040AL	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Hospital / Non Invasive Cardiology	3109 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AM	Child	DSH	SINGING RIVER HEALTH SYSTEM	Pulmonary Medicine / Pulmonary Services	3635 Bienville Blvd, Suite A	Ocean Springs	MS	Terminated
DSH250040AN	Child	DSH	SINGING RIVER HEALTH SYSTEM	SINGING RIVER HEALTH SYSTEM - Behavioral Health Services	4502 LT. EUGENE J. MAJURE DR	PASCAGOULA	MS	Terminated
DSH250040AP	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River Medical Park - Rheumatology Services	3101 Denny Ave, Suite 240	Pascagoula	MS	Terminated
DSH250040AQ	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River Clinics - Woolmarket Clinic	13034 Shriners Blvd	Biloxi	MS	Terminated
DSH250040AR	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River Clinics - Endocrinology Clinic	3635 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AS	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River - Medical Clinic- Cedar Lake	967 Cedar Lake Rd	Biloxi	MS	Terminated
DSH250040AT	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Medical Park - PET CT Scan	3535 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040AU	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River Medical Clinic- Biloxi - Medical Clinic	131 Reynoir St	Biloxi	MS	Terminated
DSH250040AV	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River - Colorectal Surgery	3101 Denny Ave	Pascagoula	MS	Terminated
DSH250040AW	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River - Surgical Services Clinic	1124 Oakleigh Rd	Ocean Springs	MS	Terminated
DSH250040AX	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River - Surgical Services Clinic	2525 Telephone Rd	Pascagoula	MS	Terminated
DSH250040AY	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River - Regional Digestive Specialists	1270 Ocean Springs Road	Ocean Springs	MS	Terminated
DSH250040AZ	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River - Regional Digestive Specialists	4511 Hospital Road	Pascagoula	MS	Terminated
DSH250040B	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River Health System Rheumatology	3603 Bienville Boulevard, Suite 203	Ocean Springs	MS	Terminated
DSH250040BA	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River - ENT Clinic	3101 Denny Ave	Pascagoula	MS	Terminated
DSH250040C	Child	DSH	SINGING RIVER HEALTH SYSTEM	Mississippi Neurology Associates	3101 Denny Avenue, Suite 240	Pascagoula	MS	Terminated
DSH250040D	Child	DSH	SINGING RIVER HEALTH SYSTEM	SRHS Clinics - Cedar Lake	1721 Medical Park Drive, Suite 101	Biloxi	MS	Terminated
DSH250040G	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River Medical Clinic - Hurley	7001 Highway 614	Hurley	MS	Terminated
DSH250040H	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River Medical Clinic-Ocean Springs	3099 Bienville Boulevard	Ocean Springs	MS	Terminated
DSH250040J	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River Medical Clinic - Vancleave	11700 Highway 57	Vancleave	MS	Terminated
DSH250040L	Child	DSH	SINGING RIVER HEALTH SYSTEM	The Neuroscience Center Ocean Springs	3603 Bienville Blvd, suite 102	Ocean Springs	MS	Terminated
DSH250040M	Child	DSH	SINGING RIVER HEALTH SYSTEM	The Neuroscience Center Pascagoula	3101 Denny Avenue, suite 210	Pascagoula	MS	Terminated
DSH250040N	Child	DSH	SINGING RIVER HEALTH SYSTEM	Hospice of Light	1121 Ocean Springs Rd.	Ocean Springs	MS	Terminated
DSH250040P	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Cancer Center	3535 Bienville Boulevard	Ocean Springs	MS	Terminated
DSH250040Q	Child	DSH	SINGING RIVER HEALTH SYSTEM	SRHS Walmart Clinic	4253 Denny Ave	Pascagoula	MS	Terminated
DSH250040R	Child	DSH	SINGING RIVER HEALTH SYSTEM	Singing River Medical Clinic- Pascagoula	2819 Denny Ave	Pascagoula	MS	Terminated
DSH250040S	Child	DSH	SINGING RIVER HEALTH SYSTEM	Hospice of Light at Lucedale	53 Dewey Street	Lucedale	MS	Terminated
DSH250040U	Child	DSH	SINGING RIVER HEALTH SYSTEM	Pulmonary Hypertension Clinic	2B Doctors Drive	Ocean Springs	MS	Terminated
DSH250040V	Child	DSH	SINGING RIVER HEALTH SYSTEM	OS Med Park/Imaging Center / Cat Scan	3535 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040W	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Medical Park MRI	3535 Bienville Blvd	Ocean Springs	MS	Terminated
DSH250040X	Child	DSH	SINGING RIVER HEALTH SYSTEM	SRH Med Park / SRH Cat Scan	3101 Denny Ave	Pascagoula	MS	Terminated
DSH250040Y	Child	DSH	SINGING RIVER HEALTH SYSTEM	SRH Med Park / SRH MRI Med Park	3101 Denny Ave	Pascagoula	MS	Terminated
DSH250040Z	Child	DSH	SINGING RIVER HEALTH SYSTEM	Ocean Springs Hospital / Surgical Services/Infusion	3109 Bienville Blvd	Ocean Springs	MS	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	7/1/2024 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		4/30/2024 12:00:00 AM	5/7/2024 6:27 AM
Details	State	Update	Termination Request	Active	To Be Terminated	5/7/2024 6:27 AM
Terminations	Termination Comments	Update	Termination Request		Entity 250040 received our filed cost report on 5/1/24 reflecting DSH% of 10.59. We emailed 340BHRSACompliance this news on 5/1/24 and were awaiting further direction. In anticipation of this we had registered 250040 and associated child sites as RRC during April 2024 window. We also ceased any 340B purchase activity beyond 4/30/24 and notified our wholesalers and 340B TPAs prior to 5/1/24. The reason we are terminating today is that I just found an email (that I had overlooked) from HRSA t	5/7/2024 6:27 AM
Terminations	Termination Date	Update	Termination Request		7/1/2024 12:00:00 AM	5/7/2024 6:27 AM
Terminations	Termination Effective Date	Update	Termination Request		5/1/2024 12:00:00 AM	5/7/2024 6:27 AM
Terminations	Termination Reason	Update	Termination Request		DSH percentage below statutory minimum	5/7/2024 6:27 AM
Contacts	Primary Contact	Update	Profile Change Request	Fratesi, Lisa D System Director of Pharmacy Singing River Health System 2288095650	Fratesi, Lisa D Executive Director of Pharmacy Singing River Health System 6623470066	2/15/2024 3:02 PM
Details	Last Recertification Date	Update	Recertification	9/13/2022 4:08:30 PM	9/8/2023 5:38:28 PM	9/8/2023 5:38 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	04672562 (MS)		7/11/2023 5:39 PM
Medicaid Billing	Medicaid: Number	Delete	Change Request	0020059 (MS)		7/11/2023 5:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		000020059	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MS	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		100000111	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MS	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		100008396	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MS	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		100008406	7/11/2023 5:39 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MS	7/11/2023 5:39 PM
Details	Last Recertification Date	Update	Recertification	9/2/2020 6:47:43 PM	9/13/2022 4:08:30 PM	9/13/2022 4:08 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	4/17/2022 6:38 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		HOS0040P	4/17/2022 6:38 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		AL	4/17/2022 6:38 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	4/17/2022 6:38 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		095912000	4/17/2022 6:38 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		FL	4/17/2022 6:38 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	4/17/2022 6:38 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		1732524	4/17/2022 6:38 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		LA	4/17/2022 6:38 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1083893937	4/17/2022 6:38 PM
Medicaid Billing	NPI: State	Insert	Change Request		AL	4/17/2022 6:38 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1083893937	4/17/2022 6:38 PM
Medicaid Billing	NPI: State	Insert	Change Request		FL	4/17/2022 6:38 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1083893937	4/17/2022 6:38 PM
Medicaid Billing	NPI: State	Insert	Change Request		LA	4/17/2022 6:38 PM
Dates	Last Date That 340B Drugs Purchased	Update	COVID-19 Reinstatement	1/1/2021 12:00:00 AM		4/15/2022 5:59 PM
Details	State	Update	COVID-19 Reinstatement	Terminated	Active	4/15/2022 5:59 PM
Dates	Start Date	Update	COVID-19 Reinstatement	4/1/2012 12:00:00 AM	3/15/2022 12:00:00 AM	4/15/2022 5:59 PM
Terminations	Termination Date	Update	COVID-19 Reinstatement	1/1/2021 12:00:00 AM		4/15/2022 5:59 PM
Terminations	Termination Effective Date	Update	COVID-19 Reinstatement	1/1/2021 12:00:00 AM		4/15/2022 5:59 PM
Terminations	Termination Reason	Update	COVID-19 Reinstatement	Change of covered entity type		4/15/2022 5:59 PM
Details	State	Update		To Be Terminated	Terminated	1/1/2021 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Hospital Type Change Request		1/1/2021 12:00:00 AM	11/18/2020 1:04 PM
Details	State	Update	Hospital Type Change Request	Active	To Be Terminated	11/18/2020 1:04 PM
Terminations	Termination Date	Update	Hospital Type Change Request		1/1/2021 12:00:00 AM	11/18/2020 1:04 PM
Terminations	Termination Effective Date	Update	Hospital Type Change Request		1/1/2021 12:00:00 AM	11/18/2020 1:04 PM
Terminations	Termination Reason	Update	Hospital Type Change Request		Change of covered entity type	11/18/2020 1:04 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1124136593 ( )		9/2/2020 6:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1083893937	9/2/2020 6:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		MS	9/2/2020 6:47 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1124136593	9/2/2020 6:47 PM
Medicaid Billing	NPI: State	Insert	Recertification		MS	9/2/2020 6:47 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1083893937 ( )		9/2/2020 6:47 PM
Details	Last Recertification Date	Update	Recertification	8/30/2019 10:35:07 AM	9/2/2020 6:47:43 PM	9/2/2020 6:47 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	12/13/2019 3:54 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		0020059	12/13/2019 3:54 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MS	12/13/2019 3:54 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1124136593	12/13/2019 3:54 PM
Details	Last Recertification Date	Update	Recertification	9/5/2018 1:02:53 PM	8/30/2019 10:35:07 AM	8/30/2019 10:35 AM
Addresses	Main Address	Update	Change Request	3635 Bienville Boulevard Ocean Springs, MS 39564	3099 Bienville Boulevard Ocean Springs, MS 39564	6/3/2019 3:03 PM
Contacts	Primary Contact	Update	Recertification	COLLAZO, MADELLINE DIRECTOR OF PHARMACY SERVICES 2288095650	Fratesi, Lisa D System Director of Pharmacy Singing River Health System 2288095650	9/5/2018 1:02 PM
Details	Last Recertification Date	Update	Recertification	11/27/2017 4:30:18 PM	9/5/2018 1:02:53 PM	9/5/2018 1:02 PM
Details	Last Recertification Date	Update	Recertification	9/7/2016 12:00:00 AM	11/27/2017 4:30:18 PM	11/27/2017 4:30 PM
Details	Entity Subname	Update	Change Request	Ocean Springs Family Medicine	Singing River Medical Clinic-Ocean Springs	10/23/2017 6:16 AM
Contacts	Authorizing Official	Update		Thompson, Heath Administrator Ancillary Services 2288181191	Thompson, Heath Allen Administrator Ancillary Services Singing River Health System 2288181191	9/18/2017 6:03 PM
Contacts	Authorizing Official	Insert			Thompson, Heath Administrator Ancillary Services 2288181191	8/7/2017 3:06 PM
Contacts	Signed By	Insert			Crews, Mike Chief Financial Officer 2284977590	6/28/2017 12:45 PM
Addresses	Main Address	Insert			3635 Bienville Boulevard Ocean Springs, MS 39564	2/17/2017 12:52 PM
Addresses	Billing Address	Insert			Singing River Health System 3109 Bienville Blvd Ocean Springs, MS 39564	2/17/2017 12:52 PM
Addresses	Shipping Address	Insert			Ocean Springs Hospital 3109 Bienville Blvd Ocean Springs, MS 39564	2/17/2017 12:52 PM
Contacts	Primary Contact	Insert			COLLAZO, MADELLINE DIRECTOR OF PHARMACY SERVICES 2288095650	2/17/2017 12:49 PM
Medicaid Billing	Medicaid: Number	Update		00020059	04672562	12/23/2016 10:52 AM
Medicaid Billing	NPI: Number	Insert			1083893937	12/23/2016 10:52 AM
Details	Entity Subname	Update		SRHS Clinics - Ocean Springs	Ocean Springs Family Medicine	12/23/2016 10:52 AM
Details	Last Recertification Date	Update		9/1/2015 12:00:00 AM	9/7/2016 12:00:00 AM	9/7/2016 6:51 PM
Details	Last Recertification Date	Update		8/25/2014 12:00:00 AM	9/1/2015 12:00:00 AM	9/1/2015 4:04 PM
Details	Last Recertification Date	Update		9/9/2013 10:09:10 PM	8/25/2014 12:00:00 AM	8/25/2014 7:22 AM
Details	Last Recertification Date	Update			9/9/2013 10:09:10 PM	9/9/2013 10:09 PM
Details	340B ID	Update		IS-DR-DSH250040H	DSH250040H	3/27/2012 6:11 PM
Dates	Participating Approval Date	Update			3/27/2012 12:00:00 AM	3/27/2012 6:11 PM
Details	State	Update		Pending	Active	3/27/2012 6:11 PM
Dates	Start Date	Update			4/1/2012 12:00:00 AM	3/27/2012 6:11 PM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG	IS-DR-DSH250040H	3/7/2012 2:51 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	12/29/2011 12:15 PM
Medicaid Billing	Medicaid: Number	Insert			00020059	12/29/2011 12:15 PM
Medicaid Billing	Medicaid: State	Insert			MS	12/29/2011 12:15 PM
Details	Last Recertification Date	Insert				12/29/2011 12:15 PM
Details	Grant Number	Insert				12/29/2011 12:15 PM
Details	340B ID	Insert			OUTPATIENT_ONLINE_REG	12/29/2011 12:15 PM
Details	Is Authorizing Official EHB Data	Insert				12/29/2011 12:15 PM
Dates	Last Date That 340B Drugs Purchased	Insert				12/29/2011 12:15 PM
Details	Medicare Provider Number	Insert			250040	12/29/2011 12:15 PM
Details	Entity Name	Insert			SINGING RIVER HEALTH SYSTEM	12/29/2011 12:15 PM
Details	Program Code	Insert			DSH	12/29/2011 12:15 PM
Details	Entity Subname	Insert			SRHS Clinics - Ocean Springs	12/29/2011 12:15 PM
Dates	Participating Approval Date	Insert				12/29/2011 12:15 PM
Details	State	Insert			Pending	12/29/2011 12:15 PM
Dates	Registration Date	Insert			12/29/2011 12:00:00 AM	12/29/2011 12:15 PM
Dates	Signed By Date	Insert			12/29/2011 12:00:00 AM	12/29/2011 12:15 PM
Dates	Start Date	Insert				12/29/2011 12:15 PM
Terminations	Termination Comments	Insert				12/29/2011 12:15 PM
Terminations	Termination Date	Insert				12/29/2011 12:15 PM
Terminations	Termination Effective Date	Insert				12/29/2011 12:15 PM
Terminations	Termination Reason	Insert				12/29/2011 12:15 PM