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DSH250058 SOUTH CENTRAL REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250058
Medicare Provider Number
250058
Additional Details
Current Program Status
Active
Registration Date
4/24/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/24/2008
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
South Central Regional Medical Center
James T. Canizaro, CFO
(601) 399-6139
Primary Contact
South Central Regional Medical Center
Shae T Miller, 34 0b Coordinator
(601) 426-4940
Addresses
Street Address
1220 JEFFERSON STREET
LAUREL, MS 39440
Billing Address
SOUTH CENTRAL REGIONAL MEDICAL CENTER
PO BOX 607
LAUREL, MS 39441
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/24/08 MOVED PO BOX TO BILL TO ADDR; ORIG PART 10/1/03-12/31/03, NOT ELIG FOR 340B 1/1/04-6/30/04
04/24/2008
May 2025
May 2025
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