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RRC440059-00 COOKEVILLE REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
COOKEVILLE REGIONAL MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC440059-00
Medicare Provider Number
440059
Additional Details
Current Program Status
Active
Registration Date
1/8/2025
Participating Start Date
4/1/2025
Participating Approval Date
2/7/2025
Last Recertification Date
Contacts
Authorizing Official
Cookeville Regional Medical Center
Marilyn Buffy Key, CEO
(931) 783-2000 Ext: 2481
Primary Contact
Cookeville Regional Medical Center
Sheldon Coffman Hitchcock, Director of Pharmacy
(931) 783-4089
Addresses
Street Address
142 WEST FIFTH STREET
COOKEVILLE, TN 38501
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 3/15/2022, terminated 4/1/2023. Reinstated 4/1/2025.
02/07/2025
May 2025
May 2025
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