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DSH180017A T.J. SAMSON COMMUNITY HOSPITAL (Terminated)
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Main Details
Name
T.J. SAMSON COMMUNITY HOSPITAL
Subdivision Name
Cave City Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180017A
Medicare Provider Number
180017
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/9/2015
Participating Start Date
4/1/2015
Participating Approval Date
2/26/2015
Last Recertification Date
8/12/2016
Termination Date
Termination Reason
1/1/2017
Site closure
Contacts
Authorizing Official
TJ Regional Health
Neil Thornbury, CEO
(270) 651-4159
Primary Contact
TJ Samson Community Hospital
Bud Wethington, CEO
(270) 651-4159
Addresses
Street Address
400N DIXIE HWY
CAVE CITY, KY 42127-9546
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
May 2025
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