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DSH040119 WHITE RIVER MEDICAL CENTER (Active)
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Main Details
Name
WHITE RIVER MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040119
Medicare Provider Number
040119
Additional Details
Current Program Status
Active
Registration Date
6/10/2009
Participating Start Date
7/1/2009
Participating Approval Date
6/14/2009
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
White River Health System
Shawna Jeffrey Ives, Controller
(870) 262-6100
Primary Contact
White River Medical Center
Maggie Williams, Pharmacy Director
(870) 262-6095
Addresses
Street Address
1710 HARRISON STREET
BATESVILLE, AR 72501
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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12/8/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
04/13/2010
April 2025
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