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DSH040014P WHITE COUNTY MEDICAL CENTER (Terminated)
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Main Details
Name
WHITE COUNTY MEDICAL CENTER
Subdivision Name
Harris Family Practice Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040014P
Medicare Provider Number
040014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/25/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/2/2016
Last Recertification Date
9/15/2022
Termination Date
Termination Reason
10/1/2023
Business decision by the Covered Entity
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
1200 McLain Street
Suite F
Newport, AR 72143
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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