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DSH250034 BAPTIST MEMORIAL HOSPITAL - NORTH MISSISSIPPI (Terminated)
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Main Details
Name
BAPTIST MEMORIAL HOSPITAL - NORTH MISSISSIPPI
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250034
Medicare Provider Number
250034
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/24/2018
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
6/4/2021
DSH percentage below statutory minimum
Contacts
Authorizing Official
Baptist Memorial Health Care Corporation
Kimberly Young, Vice President-Finance Operations
(901) 227-4080
Primary Contact
Baptist Memorial Health Care Corp
Donna C Cox, Director 340B
(901) 227-5144
Addresses
Street Address
1100 Belk Blvd
OXFORD, MS 38655-5373
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating 9/5/2008 until terminated effective 4/1/2018, reinstated effective 7/1/2018.
04/13/2018
May 2025
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