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DSH010095 HALE COUNTY HOSPITAL (Active)
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Main Details
Name
HALE COUNTY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010095
Medicare Provider Number
010095
Additional Details
Current Program Status
Active
Registration Date
7/12/2022
Participating Start Date
8/3/2022
Participating Approval Date
8/3/2022
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
Hale County Hospital
Dianne Lolley, Controller
(205) 632-6569
Primary Contact
Hale County Hospital
Tracy Moore Fondren, Pharmacy Director
(334) 624-3024 Ext: 2019
Addresses
Street Address
508 GREENE STREET
GREENSBORO, AL 36744
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2016; Terminated on 10/1/2016; Reinstated 10/1/2022.
08/02/2022
April 2025
April 2025
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