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CAH041309-00 LAWRENCE MEMORIAL HEALTH FOUNDATION, INC (Active)
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Main Details
Name
LAWRENCE MEMORIAL HEALTH FOUNDATION, INC
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH041309-00
Medicare Provider Number
041309
Additional Details
Current Program Status
Active
Registration Date
1/8/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/14/2015
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Lawrence Memorial Health Foundation Inc
Aaron C Hilton, Presdient
(870) 886-1266
Primary Contact
LAWRENCE MEMORIAL HOSPITAL
Andrea L Jones, Executive Assistant
(870) 886-1265
Addresses
Street Address
1309 W MAIN ST
WALNUT RIDGE, AR 72476-1430
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/25/15 participating 9/30/10 thru 10/1/13, not participating 10/1/13 thru 3/31/15 due to failure to recertify, reinstated based on on-line registration submitted in Jan. 2015
03/25/2015
April 2025
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