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SCH180043-00 Memorial Hospital d/b/a Manchester Memorial Hospital (Terminated)
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Main Details
Name
Memorial Hospital d/b/a Manchester Memorial Hospital
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH180043-00
Medicare Provider Number
180043
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/16/2014
Last Recertification Date
8/22/2016
Termination Date
Termination Reason
10/1/2017
Change of covered entity type
Contacts
Authorizing Official
Manchester Memorial Hospital
Steven Miller, VP Finance/CFO
(606) 598-1035
Primary Contact
Southeast Region
Diane Molnar, 340B Regional Manager
(828) 681-2168
Addresses
Street Address
210 Marie Langdon Drive
Manchester, KY 40962
Billing Address
Manchester Memorial Hospital
50 Hospital Dr
STE. G-MEM
Hendersonville, NC 28792
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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