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DSH370040 Leflore County Hospital Authority (Terminated)
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Main Details
Name
Leflore County Hospital Authority
Subdivision Name
Eastern Oklahoma Medical Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH370040
Medicare Provider Number
370040
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2013
Participating Start Date
7/1/2013
Participating Approval Date
5/3/2013
Last Recertification Date
8/10/2016
Termination Date
Termination Reason
4/1/2017
Change of covered entity type
Contacts
Authorizing Official
Mike Carter, CEO
(918) 635-3402
Primary Contact
Mike Carter, CEO
(918) 635-3402
Addresses
Street Address
105 Wall Street
Poteau, OK 74953-1148
Billing Address
LeFlore County Hospital Authority
PO Box 1148
Poteau, OK 74953-1148
Comments
Medicaid Billing
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Contract Pharmacies
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2/16/17 Changing to CAH (CAH371337) effective 4/1/17
02/16/2017
April 2025
April 2025
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