340B Drug Pricing Program Database
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CAH251315-00 Baptist Medical Center - Leake, Inc. (Active)
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Main Details
Name
Baptist Medical Center - Leake, Inc.
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251315-00
Medicare Provider Number
251315
Additional Details
Current Program Status
Active
Registration Date
4/13/2011
Participating Start Date
1/1/2014
Participating Approval Date
4/19/2011
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Baptist Memorial Health Care Corporation
Cyndi Pittman, VP Financial Operations
(901) 227-8480
Primary Contact
Baptist Memorial Health Care Corp
Donna C Cox, Director 340B
(901) 227-5144
Addresses
Street Address
1100 Hwy 16 East
CARTHAGE, MS 39051
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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11/15/13 participating 7/1/11 thru 9/30/13, not participating 10/1/13 thru 12/31/13 due to loss of eligibility, reinstated based on on-line registration submitted in Oct. 2013; 6/4/12 - Updated entity name(was BAPTIST MEDICAL CENTER LEAKE DBA LEAKE MEMORIAL HOSPITAL) 1/25/12-Updated Entity name(was LEAKE COUNTY BOARD OF TRUSTEES DBA LEAKE MEMORIAL HOSPITAL)
11/15/2013
6/4/12 - Updated entity name(was BAPTIST MEDICAL CENTER LEAKE DBA LEAKE MEMORIAL HOSPITAL) 1/25/12-Updated Entity name(was LEAKE COUNTY BOARD OF TRUSTEES DBA LEAKE MEMORIAL HOSPITAL)
06/04/2012
1/25/12-Updated Entity name(was LEAKE COUNTY BOARD OF TRUSTEES DBA LEAKE MEMORIAL HOSPITAL)
01/25/2012
May 2025
May 2025
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