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CAH421302-00 FAIRFIELD MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
FAIRFIELD MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH421302-00
Medicare Provider Number
421302
Additional Details
Current Program Status
Terminated
Registration Date
11/30/2010
Participating Start Date
4/1/2015
Participating Approval Date
11/30/2010
Last Recertification Date
8/15/2018
Termination Date
Termination Reason
1/1/2019
Site closure
Contacts
Authorizing Official
Fairfield Memorial Hospital
Suzanne Doscher, Chief Executive Officer
(803) 635-0233
Primary Contact
Fairfield Memorial Hospital
Pat Walker, Executive Secretary
(803) 632-0233
Addresses
Street Address
102 US HWY 321 BYPASS NORTH
WINNSBORO, SC 29180
Billing Address
FAIRFIELD MEMORIAL HOSPITAL
PO BOX 620
WINNSBORO, SC 29180
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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03/15/15- CE reinstated effective 4/1/2015; was participating from 1/1/2011 to 9/30/2013; not participating from 10/1/2013 to 03/31/2015 due to [failure to recertify].”
03/14/2015
April 2025
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