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CAH251302-11 PIONEER HEALTH SERVICES OF MONROE COUNTY, INC. D/B/A PIONEER COMMUNITY HOSPITAL (Terminated)
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Main Details
Name
PIONEER HEALTH SERVICES OF MONROE COUNTY, INC. D/B/A PIONEER COMMUNITY HOSPITAL
Subdivision Name
Pioneer Outpatient Behavioral Health of Okolona
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251302-11
Medicare Provider Number
251302
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/15/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/19/2014
Last Recertification Date
8/29/2016
Termination Date
Termination Reason
7/1/2017
Site closure
Contacts
Authorizing Official
Boa Vida Hospital of Aberdeen LLC., dba Monroe Regional Hospital
Chris Chandler, CEO
(662) 369-2455
Primary Contact
Monroe Regional Hospital
Amanda Williams, Pharmacy Director
(662) 369-2455
Addresses
Street Address
253 West Main Street
Okolona, MS 38860
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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