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DSH420020C GEORGETOWN MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
GEORGETOWN MEMORIAL HOSPITAL
Subdivision Name
Tidelands Health Cancer Care Network at Murrells Inlet
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH420020C
Medicare Provider Number
420020
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2013
Participating Start Date
3/15/2022
Participating Approval Date
1/22/2013
Last Recertification Date
9/6/2023
Termination Date
Termination Reason
4/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Georgetown Memorial Hospital
Gayle Lynn Resetar, COO
(843) 527-7100
Primary Contact
Georgetown Memorial Hospital
Darrell Willm, Pharmacy Director
(843) 457-8351
Addresses
Street Address
4181 HIGHWAY 17
MURRELLS INLET, SC 29576-5019
Billing Address
Tidelands Health Cancer Care Network at Murrells Inlet
606 BLACK RIVER RD
GEORGETOWN, SC 29440-3304
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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6/8/15 Hospital previously participated as DSH420020C from 4/1/2013-1/1/2014 and RRC420020-03 from 1/1/2014-6/30/2015; converted to a DSH hospital effective 7/1/2015.
06/08/2015
June 2025
June 2025
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