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DSH440057 CLAIBORNE MEDICAL CENTER (Terminated)
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Main Details
Name
CLAIBORNE MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440057
Medicare Provider Number
440057
Additional Details
Current Program Status
Terminated
Registration Date
4/19/2007
Participating Start Date
7/1/2007
Participating Approval Date
4/20/2007
Last Recertification Date
9/4/2014
Termination Date
Termination Reason
10/1/2015
DSH percentage below statutory minimum
Contacts
Authorizing Official
TIM S. BROWN, ADMINISTRATOR
(423) 626-4211
Primary Contact
TIM S. BROWN, ADMINISTRATOR
(423) 626-4211
Addresses
Street Address
1850 OLD KNOXVILLE ROAD
TAZEWELL, TN 37879
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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