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DSH180044A PIKEVILLE MEDICAL CENTER, INC. (Terminated)
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Main Details
Name
PIKEVILLE MEDICAL CENTER, INC.
Subdivision Name
Pikeville Medical Center, Inc. Leonard Lawson Cancer Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180044A
Medicare Provider Number
180044
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/3/2013
Participating Start Date
7/1/2013
Participating Approval Date
6/18/2013
Last Recertification Date
8/15/2018
Termination Date
Termination Reason
10/1/2019
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Pikeville Medical Center
MICHELLE HAGY, CFO
(606) 430-3519
Primary Contact
Pikeville Medical Center inc.
Marcus Conley, Assistant Chief Financial Officer
(606) 430-3509
Addresses
Street Address
172 South Mayo Trail
Pikeville, KY 41501
Billing Address
Pikeville Medical Center, Inc.
P.O. Box 2917
Pikeville, KY 41502-2917
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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