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DSH040067 MAGNOLIA REGIONAL HEALTH SYSTEM INC D/B/A MAGNOLIA REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
MAGNOLIA REGIONAL HEALTH SYSTEM INC D/B/A MAGNOLIA REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040067
Medicare Provider Number
040067
Additional Details
Current Program Status
Terminated
Registration Date
5/24/2006
Participating Start Date
10/1/2016
Participating Approval Date
5/24/2006
Last Recertification Date
8/15/2023
Termination Date
Termination Reason
7/1/2024
Change of covered entity type
Contacts
Authorizing Official
Magnolia Regional Medical Center
Brett Kinman, CEO
(870) 235-3212
Primary Contact
Magnolia Regional Medical Center
LeeAnn R Scheer, 340B Consultant
(512) 789-8341
Addresses
Street Address
101 HOSPITAL DRIVE
MAGNOLIA, AR 71753
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Comments 8/26/16 Previously participated as an SCH from 10/1/13 through 9/30/16, previously participated as a DSH from 7/1/06 through 9/30/13, reinstated as DSH effective 10/1/16
08/26/2016
April 2025
April 2025
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