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CH041370 PERRY COUNTY MEDICAL CENTER, INC. (Active)
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Main Details
Name
PERRY COUNTY MEDICAL CENTER, INC.
Subdivision Name
PERRY COUNTY MEDICAL CENTER, INC.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-004762
340B ID
CH041370
Grant Number
H80CS00346
Additional Details
Current Program Status
Active
Registration Date
4/1/2005
Participating Start Date
4/1/2005
Participating Approval Date
3/8/2005
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Perry County Medical Center, Inc.
PHILLIP TATUM, CEO
(931) 589-2104
Primary Contact
Perry County Medical Center, Inc.
Luke Cagle, CFO
(931) 589-2104
Addresses
Street Address
115 E BROOKLYN STREET
LINDEN, TN 37096
Billing Address
PERRY COUNTY MEDICAL CENTER, INC.
PO BOX 916
LINDEN, TN 37096-0916
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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4/17/12-Changed primary contact person was (BARBARA HEADY); 10/6/11 - Changed AO; NEW SITE 04/1/05
04/17/2012
NEW SITE 04/1/05
08/12/2005
May 2025
May 2025
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