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DSH250077C WAYNE GENERAL HOSPITAL (Active)
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Main Details
Name
WAYNE GENERAL HOSPITAL
Subdivision Name
WAYNESBORO FAMILY MEDICINE AND OBSTETRICS
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250077C
Medicare Provider Number
250077
Outpatient Facility Provider Number
258546
Additional Details
Current Program Status
Active
Registration Date
3/17/2010
Participating Start Date
4/1/2010
Participating Approval Date
3/17/2010
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Wayne General Hospital
Andrew Porter, CEO
(601) 735-5151 Ext: 100
Primary Contact
Wayne General Hospital
Clinton Eaves, CFO
(601) 735-7103
Addresses
Street Address
951 MATTHEW DRIVE
SUITE A
WAYNESBORO, MS 39367
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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