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DSH250040D SINGING RIVER HEALTH SYSTEM (Terminated)
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Main Details
Name
SINGING RIVER HEALTH SYSTEM
Subdivision Name
SRHS Clinics - Cedar Lake
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250040D
Medicare Provider Number
250040
Outpatient Facility Provider Number
250040
Additional Details
Current Program Status
Terminated
Registration Date
12/29/2011
Participating Start Date
4/1/2012
Participating Approval Date
3/27/2012
Last Recertification Date
8/25/2014
Termination Date
Termination Reason
10/1/2015
Site closure
Contacts
Authorizing Official
Singing River Health System
Heath Allen Thompson, Administrator Ancillary Services
(228) 818-1191
Primary Contact
MADELLINE COLLAZO, DIRECTOR OF PHARMACY SERVICES
(228) 809-5650
Addresses
Street Address
1721 Medical Park Drive, Suite 101
Biloxi, MS 39532
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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