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DSH180029A HAZARD ARH REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
HAZARD ARH REGIONAL MEDICAL CENTER
Subdivision Name
ARH MEDICAL MALL
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180029A
Medicare Provider Number
180029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/10/2009
Participating Start Date
7/1/2009
Participating Approval Date
6/14/2009
Last Recertification Date
8/16/2016
Termination Date
Termination Reason
10/1/2017
Site closure
Contacts
Authorizing Official
Appalachian Regional Healthcare
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Primary Contact
Appalachian Regional Healthcare
Jeffrey Akers, CEO of Pharmaceutical Services
(606) 616-2296
Addresses
Street Address
210 BLACK GOLD BLVD
HAZARD, KY 41701
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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12/27/11 remove medicaid #, add NPI, change AO from Grossman to Hayne and PC from Short to Akers JH
12/27/2011
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