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DSH250099 GREENWOOD LEFLORE HOSPITAL (Active)
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Main Details
Name
GREENWOOD LEFLORE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250099
Medicare Provider Number
250099
Additional Details
Current Program Status
Active
Registration Date
6/4/2008
Participating Start Date
10/1/2001
Participating Approval Date
6/4/2008
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Greenwood Lefore Hospital
Dawne Holmes, CFO
(662) 459-7119
Primary Contact
Greenwood Leflore Hospital
Spencer Jennings, Director of Pharmacy
(662) 459-2633
Addresses
Street Address
1401 RIVER ROAD
GREENWOOD, MS 38930
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/7/12 add new billing address
03/07/2012
April 2025
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