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DSH420070B PRISMA HEALTH TUOMEY HOSPITAL (Terminated)
Main Details
Name
PRISMA HEALTH TUOMEY HOSPITAL
Subdivision Name
Tuomey Outpatient Surgery Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH420070B
Medicare Provider Number
420070
Outpatient Facility Provider Number
Contacts
Authorizing Official
Prisma Health Tuomey
Michelle Logan-Owens, Chief Executive Officer
(803) 774-9035
Primary Contact
Prisma Health
Jennifer Davis Bair, Director of Pharmacy
(803) 434-3769
Additional Details
Current Program Status
Terminated
Registration Date
10/12/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/4/2015
Last Recertification Date
8/22/2019
Termination Date
10/1/2020
Termination Reason
Business decision by the Covered Entity
Addresses
Street Address
100 North Sumter Street
Suite 100
Sumter, SC 29150
Billing Address
Tuomey Healthcare System
129 North Washington Street
Sumter, SC 29150
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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