Covered Entity Details

DSH010120 MONROE COUNTY HOSPITAL (ToBeTerminated)

Main Details

Name

MONROE COUNTY HOSPITAL

Subdivision Name

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH010120

Medicare Provider Number

010120

Additional Details

Current Program Status

ToBeTerminated

Registration Date

2/27/2006

Participating Start Date

4/1/2006

Participating Approval Date

2/28/2006

Last Recertification Date

8/16/2024

Termination Date
Termination Reason

7/1/2025
DSH percentage below statutory minimum

Contacts

Authorizing Official

Monroe County Hospital
Brandon Nelson, Director of Pharmacy
(251) 743-7413

Primary Contact

Monroe County Hospital
Brooke Lowery, Pharmacy Technician
(251) 743-7563

Addresses

Street Address

2016 S Alabama Ave
MONROEVILLE, AL 36460

Billing Address

Monroe County Hospital
2016 S Alabama Ave
P.O. Box 886
Monroeville, AL 36461

Comment	Last Updated On
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2/16/12 add medicaid # cahnge AO/PC 2/4/2010- DOC RECD TO CONFIRM ELIG DSH ADJ%; AND UPDATE AUTH. OFFICIAL AND CONTACT PERSON INFO.; 11/21/08-DOC RECD TO CONFIRM ELIG DSH ADJ%	02/16/2012
2/4/2010- DOC RECD TO CONFIRM ELIG DSH ADJ%; AND UPDATE AUTH. OFFICIAL AND CONTACT PERSON INFO.; 11/21/08-DOC RECD TO CONFIRM ELIG DSH ADJ%	02/04/2010

340B Drug Pricing Program Database