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SCH250057-00 KINGS DAUGHTERS MEDICAL CENTER (Active)
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Main Details
Name
KINGS DAUGHTERS MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH250057-00
Medicare Provider Number
250057
Additional Details
Current Program Status
Active
Registration Date
11/15/2010
Participating Start Date
1/1/2011
Participating Approval Date
11/17/2010
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
King's Daughters Medical Center
Amy L Walker, Chief Administrative Officer
(662) 820-2693
Primary Contact
Kings' Daughters Medical Center
Karen Wallace Freeman, Pharmacy Director
(601) 835-9371
Addresses
Street Address
427 HWY 51 N
BROOKHAVEN, MS 39601
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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