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DSH250040U SINGING RIVER HEALTH SYSTEM (Terminated)
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Main Details
Name
SINGING RIVER HEALTH SYSTEM
Subdivision Name
Pulmonary Hypertension Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250040U
Medicare Provider Number
250040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/15/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/28/2015
Last Recertification Date
9/5/2018
Termination Date
Termination Reason
10/1/2019
Other
Contacts
Authorizing Official
Singing River Health System
Heath Allen Thompson, Administrator Ancillary Services
(228) 818-1191
Primary Contact
Singing River Health System
Lisa D Fratesi, Executive Director of Pharmacy
(662) 347-0066
Addresses
Street Address
2B Doctors Drive
Ocean Springs, MS 39564
Billing Address
Ocean Springs Hospital
3109 Bienville Blvd
Ocean Springs, MS 39564
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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