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DSH340002W MISSION HOSPITALS, INC. (Terminated)
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Main Details
Name
MISSION HOSPITALS, INC.
Subdivision Name
Mission Child Medical Evaluation
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340002W
Medicare Provider Number
340002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/14/2014
Participating Start Date
7/1/2014
Participating Approval Date
5/8/2014
Last Recertification Date
8/31/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
Mission Health System
Paul L McDowell, CFO
(828) 213-0184
Primary Contact
Mission Health
Alan K. Knudsen, Pharmacy Specialist, 340B Program
(828) 213-4213
Addresses
Street Address
11 Vanderbilt Park Drive
Asheville, NC 28803
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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