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DSH110104 CRISP REGIONAL HOSPITAL, INC. (Active)
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Main Details
Name
CRISP REGIONAL HOSPITAL, INC.
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110104
Medicare Provider Number
110104
Additional Details
Current Program Status
Active
Registration Date
8/23/2007
Participating Start Date
1/1/2005
Participating Approval Date
8/23/2007
Last Recertification Date
9/9/2024
Contacts
Authorizing Official
CRISP REGIONAL HOSPITAL, INC.
Jessica Carter, CFO
(229) 276-3130
Primary Contact
CRISP REGIONAL HOSPITAL, INC.
Whitney Hill Brown, Director of Pharmacy
(229) 276-3386
Addresses
Street Address
902 7TH STREET NORTH
CORDELE, GA 31015-5007
Billing Address
Crisp Regional Hospital, Inc.
PO Box 5007
Cordele, GA 31010
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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