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DSH180013 THE MEDICAL CENTER - BOWLING GREEN (Active)
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Main Details
Name
THE MEDICAL CENTER - BOWLING GREEN
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180013
Medicare Provider Number
180013
Additional Details
Current Program Status
Active
Registration Date
10/18/2007
Participating Start Date
4/1/2005
Participating Approval Date
10/18/2007
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Med Center Health
Wade R. Stone, Executive Vice President
(270) 745-1504
Primary Contact
Commonwealth Health Corporation
Caleb Benningfield, Pharmacist
(270) 745-1640
Addresses
Street Address
250 PARK STREET
BOWLING GREEN, KY 42101
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/7/12 add npi
03/07/2012
May 2025
May 2025
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