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DSH180017N TJ SAMSON COMMUNITY HOSPITAL (Active)
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Main Details
Name
TJ SAMSON COMMUNITY HOSPITAL
Subdivision Name
Family Practice Clinic (Resident Clinic)
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180017N
Medicare Provider Number
180017
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2016
Participating Start Date
7/1/2016
Participating Approval Date
4/28/2016
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
TJ Regional Health
Neil Thornbury, CEO
(270) 651-4159
Primary Contact
TJ Regional Health
John Thomas Rogers, Compliance Officer
(270) 651-4513
Addresses
Street Address
1325 NORTH RACE STREET
GLASGOW, KY 42141-3427
Billing Address
TJ Samson Community Hospital
1301 North Race Street
Glasgow, KY 42141
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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