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DSH420020E GEORGETOWN MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
GEORGETOWN MEMORIAL HOSPITAL
Subdivision Name
TIDELANDS HEALTH WOUND CARE AND INFUSION CENTER AT MURRELLS INLET/TIDELANDS HEALTH ECHO/VASCULAR LAB AT MURRELLS INLET
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH420020E
Medicare Provider Number
420020
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/2/2015
Participating Start Date
3/15/2022
Participating Approval Date
6/10/2015
Last Recertification Date
9/6/2023
Termination Date
Termination Reason
4/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Georgetown Memorial Hospital
Gayle Lynn Resetar, COO
(843) 527-7100
Primary Contact
Georgetown Memorial Hospital
Darrell Willm, Pharmacy Director
(843) 457-8351
Addresses
Street Address
4367 RIVERWOOD DR UNIT 140
MURRELLS INLET, SC 29576-4381
Billing Address
TIDELANDS HEALTH WOUND CARE AND INFUSION CENTER AT MURRELLS INLET/TIDELANDS HEALTH ECHO/VASCULAR LAB
606 BLACK RIVER RD
GEORGETOWN, SC 29440-3304
Comments
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