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DSH040119J WHITE RIVER MEDICAL CENTER (Active)
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Main Details
Name
WHITE RIVER MEDICAL CENTER
Subdivision Name
Batesville Oncology Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040119J
Medicare Provider Number
040119
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/4/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/6/2014
Last Recertification Date
8/30/2024
Contacts
Authorizing Official
White River Health System
Shawna Jeffrey Ives, Controller
(870) 262-6100
Primary Contact
White River Medical Center
Maggie Williams, Pharmacy Director
(870) 262-6095
Addresses
Street Address
1710 HARRISON STREET
BATESVILLE, AR 72501
Billing Address
Batesville Oncology Clinic
PO Box 2695
Batesville, AR 72503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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