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CH04137A PERRY COUNTY MEDICAL CENTER INC (Active)
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Main Details
Name
PERRY COUNTY MEDICAL CENTER INC
Subdivision Name
THREE RIVERS COMMUNITY HLTH GRP-HICKMAN
Type
HRSA-Funded Health Center
Site ID
BPS-H80-000350
340B ID
CH04137A
Grant Number
H80CS00346
Additional Details
Current Program Status
Active
Registration Date
10/18/2007
Participating Start Date
1/1/2008
Participating Approval Date
10/26/2007
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Perry County Medical Center, Inc.
PHILLIP TATUM, CEO
(931) 589-2104
Primary Contact
Perry County Medical Center, Inc.
Luke Cagle, CFO
(931) 589-2104
Addresses
Street Address
7723 Clearview Church Ln STE 100
Lyles, TN 37098-1609
Billing Address
PERRY COUNTY MEDICAL CENTER, INC.
P O Box 916
LINDEN, TN 37096-0916
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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4/17/12-Changed the primary contact person was (BARBARA HEADY); 10/6/11 - Updated AO
04/17/2012
May 2025
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