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DSH040014Y WHITE COUNTY MEDICAL CENTER (Terminated)
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Main Details
Name
WHITE COUNTY MEDICAL CENTER
Subdivision Name
Newport Cardiology Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040014Y
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
8/17/2018
Termination Date
Termination Reason
7/1/2019
Site closure
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
2000 McLain Street
Newport, AR 72112
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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