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SCH420071-04 SELF REGIONAL HEALTHCARE (Approved)
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Main Details
Name
SELF REGIONAL HEALTHCARE
Subdivision Name
Self Regional Healthcare Outpatient Cardiology - Outpatient Cardiology
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH420071-04
Medicare Provider Number
420071
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/11/2025
Participating Start Date
7/1/2025
Participating Approval Date
4/16/2025
Last Recertification Date
Contacts
Authorizing Official
Self Regional Healthcare
Clint Stewart, VP, Chief Financial Officer
(864) 725-4248
Primary Contact
Self Regional Healthcare
Jennifer G Elrod, Director of Pharmacy Services
(864) 725-5774
Addresses
Street Address
421 Epting Avenue
Greenwood, SC 29646
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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