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DSH180012A HARDIN MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
HARDIN MEMORIAL HOSPITAL
Subdivision Name
HELMWOOD RADIOLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180012A
Medicare Provider Number
180012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
5/30/2010
Participating Start Date
4/1/2017
Participating Approval Date
5/30/2010
Last Recertification Date
Termination Date
Termination Reason
1/1/2018
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Hardin Memorial Hospital
Thomas Carrico, Chief Operating Officer
(270) 706-5321
Primary Contact
Brian Steward, Reimbursement Manager
(270) 706-1663
Addresses
Street Address
914 NORTH DIXIE AVENUE 307
ELIZABETHTOWN, KY 42701-2537
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Previously participated as a DSH from 7/1/2010-7/1/2011. Reinstated as a DSH 4/1/2017. 6/15/2010- SUBMITTED DOC. TO SUPPORT ELIG. DSH PERCENTAGE.
03/15/2017
6/15/2010- SUBMITTED DOC. TO SUPPORT ELIG. DSH PERCENTAGE.
07/01/2011
April 2025
April 2025
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