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DSH180017 TJ SAMSON COMMUNITY HOSPITAL (Active)
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Main Details
Name
TJ SAMSON COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180017
Medicare Provider Number
180017
Additional Details
Current Program Status
Active
Registration Date
7/1/2005
Participating Start Date
7/1/2005
Participating Approval Date
6/1/2005
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
TJ Regional Health
Neil Thornbury, CEO
(270) 651-4159
Primary Contact
TJ Regional Health
John Thomas Rogers, Compliance Officer
(270) 651-4513
Addresses
Street Address
1301 NORTH RACE STREET
GLASGOW, KY 42141
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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2/23/12 add medicaid/NPI # RURAL NEW ENTRY 7/1/05
02/23/2012
RURAL NEW ENTRY 7/1/05
08/31/2009
May 2025
May 2025
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