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SCH180043-02 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
Manchester Memorial Hospital - Mountain Medical Physical Therapy
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH180043-02
Medicare Provider Number
180043
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/15/2014
Participating Start Date
7/1/2014
Participating Approval Date
6/13/2014
Last Recertification Date
9/3/2015
Termination Date
Termination Reason
4/1/2016
Site closure
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
15 Highway 290
McKee, KY 40447
Billing Address
Manchester Memorial Hospital
50 Hospital Dr.
STE. G-MEM
Hendersonville, NC 28792
Comments
Medicaid Billing
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Contract Pharmacies
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