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DSH040014 WHITE COUNTY MEDICAL CENTER (Active)
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Main Details
Name
WHITE COUNTY MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040014
Medicare Provider Number
040014
Additional Details
Current Program Status
Active
Registration Date
5/23/2007
Participating Start Date
4/1/2015
Participating Approval Date
5/23/2007
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
White County Medical Center
Stuart Randall Hill, VP Treasurer
(501) 380-1004
Primary Contact
White County Medical Center
Scotty Terl Parker, AVP Ancillary Services
(501) 380-1382
Addresses
Street Address
3214 East Race Avenue
SEARCY, AR 72143
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/12/15 participating 7/1/07 thru 12/31/13 as DSH hospital, 340B ID terminated when hospital converted to SCH entity type effective 1/1/14, changed entity type back to DSH effective 4/1/15 based on on-line registration submitted in January 2015; 3/24/2010- DOCUMENT RECD. TO CONFIRM ELIGIBLE OWNERSHIP TYPE; 12/13/08 OPA NOTIFIED ON 11/25/08 DOC RECD TO CONFIRM ELIG DSH ADJ%
03/12/2015
3/24/2010- DOCUMENT RECD. TO CONFIRM ELIGIBLE OWNERSHIP TYPE; 12/13/08 OPA NOTIFIED ON 11/25/08 DOC RECD TO CONFIRM ELIG DSH ADJ%
05/18/2010
April 2025
April 2025
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