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CAH251302-36 BOA VIDA HOSPITAL OF ABERDEEN, MS, LLC, D/B/A MONROE REGIONAL HOSPITAL (Active)
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Main Details
Name
BOA VIDA HOSPITAL OF ABERDEEN, MS, LLC, D/B/A MONROE REGIONAL HOSPITAL
Subdivision Name
MRHMG - Caretime Medical Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251302-36
Medicare Provider Number
251302
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/21/2024
Last Recertification Date
Contacts
Authorizing Official
Boa Vida Hospital of Aberdeen LLC., dba Monroe Regional Hospital
Chris Chandler, CEO
(662) 369-2455
Primary Contact
Boa Vida Healthcare
Lisa Tang, 340B Program Director
(317) 324-1466
Addresses
Street Address
1506 US 278A
Amory, MS 38821
Billing Address
Boa Vida Hospital of Aberdeen, MS LLC
10996 Four Seasons Place
Crown Point, IN 46307
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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