340B Drug Pricing Program Database

Name

SINGING RIVER HEALTH SYSTEM

Subdivision Name

SRHS Walmart Clinic

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH250040Q

Medicare Provider Number

250040

Outpatient Facility Provider Number

Current Program Status

Terminated

Registration Date

4/15/2013

Participating Start Date

7/1/2013

Participating Approval Date

5/16/2013

Last Recertification Date

9/7/2016

Termination Date
Termination Reason

4/1/2017
Site closure

Authorizing Official

Singing River Health System
Heath Allen Thompson, Administrator Ancillary Services
(228) 818-1191

Primary Contact

Singing River Health System
Heath Allen Thompson, Administrator Ancillary Services
(228) 818-1191

Street Address

4253 Denny Ave
Pascagoula, MS 39581

Billing Address

Singing River Health System
2809 Denny Avenue
Pascagoula, MS 39581