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DSH100175 DESOTO MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
DESOTO MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100175
Medicare Provider Number
100175
Additional Details
Current Program Status
Terminated
Registration Date
12/6/2007
Participating Start Date
1/1/2008
Participating Approval Date
12/7/2007
Last Recertification Date
8/28/2019
Termination Date
Termination Reason
10/1/2020
DSH percentage below statutory minimum
Contacts
Authorizing Official
DeSoto County Hospital District
Daniel P. Hogan, CFO
(863) 494-8414
Primary Contact
DeSoto County Hospital District
Tabitha McPherson, Director of Pharmacy
(863) 494-8433
Addresses
Street Address
900 NORTH ROBERT AVENUE
ARCADIA, FL 34266
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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