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CAH251325-01 COVINGTON COUNTY HOSPITAL (Active)
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Main Details
Name
COVINGTON COUNTY HOSPITAL
Subdivision Name
Green Tree Family Medical Clinic
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251325-01
Medicare Provider Number
251325
Outpatient Facility Provider Number
258558
Additional Details
Current Program Status
Active
Registration Date
10/4/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/3/2013
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Covington County Hospital
Gregg Gibbes, CEO
(601) 765-6711
Primary Contact
Covington County Hospital
Delilah Hudson, Controller
(601) 765-6711 Ext: 126
Addresses
Street Address
603 S Main St
Mt Olive, MS 39119
Billing Address
Green Tree Family Medical Clinic
P O Box 1107
Mt Olive, MS 39119
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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