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DSH180017J TJ SAMSON COMMUNITY HOSPITAL (Terminated)
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Main Details
Name
TJ SAMSON COMMUNITY HOSPITAL
Subdivision Name
Women's Health
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180017J
Medicare Provider Number
180017
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2015
Participating Start Date
4/1/2015
Participating Approval Date
2/26/2015
Last Recertification Date
8/29/2018
Termination Date
Termination Reason
10/1/2019
Site closure
Contacts
Authorizing Official
TJ Regional Health
Neil Thornbury, CEO
(270) 651-4159
Primary Contact
TJ Regional Health
John Thomas Rogers, Compliance Officer
(270) 651-4513
Addresses
Street Address
310N L ROGERS WELLS BLVD
GLASGOW, KY 42141-1300
Billing Address
TJ Samson Community Hospital
1301 NORTH RACE STREET
GLASGOW, KY 42141
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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