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DSH040014F WHITE COUNTY MEDICAL CENTER (Terminated)
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Main Details
Name
WHITE COUNTY MEDICAL CENTER
Subdivision Name
Westside Family Med Clinic / Family Medicine
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040014F
Medicare Provider Number
040014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/23/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/12/2015
Last Recertification Date
9/15/2022
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
White County Medical Center
Stuart Randall Hill, VP Treasurer
(501) 380-1004
Primary Contact
White County Medical Center
Scotty Terl Parker, AVP Ancillary Services
(501) 380-1382
Addresses
Street Address
103 WOODLANE DR
WESTSIDE FAMILY MEDICAL CLINIC
SEARCY, AR 72143-6113
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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