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CAH441309-00 MARSHALL MEDICAL CENTER (Active)
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Main Details
Name
MARSHALL MEDICAL CENTER
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH441309-00
Medicare Provider Number
441309
Additional Details
Current Program Status
Active
Registration Date
8/25/2010
Participating Start Date
9/21/2010
Participating Approval Date
8/26/2010
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Marshall Medical Center
PHYLLIS BROWN, CHIEF EXECUTIVE OFFICER
(931) 359-6241 Ext: 3306
Primary Contact
Maury Regional Outpatient Pharmacy
Drew Keller, Pharmacy Manager
(931) 381-1111 Ext: 1134
Addresses
Street Address
1080 NORTH ELLINGTON PKWY
LEWISBURG, TN 37091
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/4/2012 - Removed medicaid #s(10078618,1000189) and replaced with 0441309. 9/29/2010 - ADDRESS CHANGED FROM #1280 TO CORRECT TYPO.
04/04/2012
9/29/2010 - ADDRESS CHANGED FROM #1280 TO CORRECT TYPO.
09/29/2010
June 2025
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