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DSH340023Z PARK RIDGE HEALTH (Terminated)
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Main Details
Name
PARK RIDGE HEALTH
Subdivision Name
Southeastern Sports Medicine of Hendersonville
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340023Z
Medicare Provider Number
340023
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
8/15/2012
Participating Start Date
10/1/2012
Participating Approval Date
8/30/2012
Last Recertification Date
8/22/2014
Termination Date
Termination Reason
7/1/2015
Site closure
Contacts
Authorizing Official
Park Ridge Health
Ella Stenstrom, CFO
(828) 681-2102
Primary Contact
Southeast Region
Diane Molnar, 340B Regional Manager
(828) 681-2168
Addresses
Street Address
204 South King Street
Hendersonville, NC 28792
Billing Address
Park Ridge Health
50 Hospital Drive
Suite G-A
Hendersonville, NC 28792
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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