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CAH251329-00 GREENE COUNTY HOSPITAL (Terminated)
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Main Details
Name
GREENE COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251329-00
Medicare Provider Number
251329
Additional Details
Current Program Status
Terminated
Registration Date
2/18/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/8/2011
Last Recertification Date
8/25/2023
Termination Date
Termination Reason
10/1/2024
Change of covered entity type (non-hospital)
Contacts
Authorizing Official
George Regional Health System
GREG HAVARD, CHIEF EXECUTIVE OFFICER
(601) 947-9148
Primary Contact
George County Hospital
Carman Walley, DOP
(601) 673-6181
Addresses
Street Address
1017 JACKSON AVENUE
LEAKESVILLE, MS 39451-9105
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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