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DSH250123S SINGING RIVER GULFPORT (Terminated)
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Main Details
Name
SINGING RIVER GULFPORT
Subdivision Name
Outpatient Clinical Services Pascagoula - Clinical Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH250123S
Medicare Provider Number
250123
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/7/2024
Last Recertification Date
Termination Date
Termination Reason
4/1/2025
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
2809 Denny Avenue
Pacagoula, MS 39581
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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