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DSH440049 METHODIST HEALTHCARE - MEMPHIS HOSPITALS (Active)
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Main Details
Name
METHODIST HEALTHCARE - MEMPHIS HOSPITALS
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440049
Medicare Provider Number
440049
Additional Details
Current Program Status
Active
Registration Date
4/25/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/25/2008
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Methodist Healthcare - Memphis Hospitals
Chuck Lane, SVP/Associate CFO
(901) 516-0549
Primary Contact
Methodist Le Bonheur Healthcare
Chris Hilty, Director - Pharmacy Supply Chain
(901) 516-7570
Addresses
Street Address
1265 Union Ave
Memphis, TN 38104
Billing Address
Methodist Healthcare - Memphis Hospitals
P.O. Box 41058
Memphis, TN 38174
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/16/10 SHIPPING ADDED - 7/15/04 ADDR CORRECTION (WAS 1265 UNION AVE)-9/16/10 UPDATED ADDR (WAS 221 S. CLAYBROOK MEMPHIS TN 38104)
09/16/2010
May 2025
May 2025
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