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DSH180009M KING'S DAUGHTERS MEDICAL CENTER (Active)
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Main Details
Name
KING'S DAUGHTERS MEDICAL CENTER
Subdivision Name
GRAYSON URGENT CARE CENTER
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180009M
Medicare Provider Number
180009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
11/9/2011
Participating Start Date
1/1/2012
Participating Approval Date
12/14/2011
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
King's Daughters Medical Center
Sara Marks, Interim CEO
(606) 408-4401
Primary Contact
King's Daughters Medical Center
Debbie Bell, 340B Coordinator
(606) 408-9503
Addresses
Street Address
609 NORTH CAROL MALONE BLVD
SUITE 100
Grayson, KY 41143
Billing Address
Kings Daughters Medical Center
Po Box 151
Ashland, KY 41105-0151
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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