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DSH490114 LONESOME PINE HOSPITAL (Active)
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Main Details
Name
LONESOME PINE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490114
Medicare Provider Number
490114
Additional Details
Current Program Status
Active
Registration Date
8/31/2006
Participating Start Date
10/1/2006
Participating Approval Date
8/31/2006
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Ballad Health
Shane Hilton, EVP, Chief Financial Officer
(423) 302-3467
Primary Contact
Ballad Health
Trish Tanner, VP, Chief Pharmacy Officer
(423) 302-3532
Addresses
Street Address
1990 HOLTON AVENUE EAST
BIG STONE GAP, VA 24219
Billing Address
Wellmont Health System
Lonesome Pine Hospital
P.O. Box 659
Kingsport, TN 37662
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/07 - DSH ADJ % >11.75
02/17/2011
April 2025
April 2025
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