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CAH251324-00 WALTHALL GENERAL HOSPITAL (Active)
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Main Details
Name
WALTHALL GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251324-00
Medicare Provider Number
251324
Additional Details
Current Program Status
Active
Registration Date
5/31/2011
Participating Start Date
10/1/2011
Participating Approval Date
9/27/2011
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Forrest General Hospital
Ben Hester, CFO
(601) 288-4225
Primary Contact
Walthall General Hospital
Thad Thomas, Pharmacy Operations Coordinator
(601) 876-0425
Addresses
Street Address
100 HOSPITAL DRIVE
TYLERTOWN, MS 39667-2022
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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10/27/11 - Added medicaid #
10/27/2011
April 2025
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