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DSH180001 ST ELIZABETH FT THOMAS (Terminated)
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Main Details
Name
ST ELIZABETH FT THOMAS
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180001
Medicare Provider Number
180001
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2016
Participating Start Date
3/15/2022
Participating Approval Date
8/12/2016
Last Recertification Date
8/25/2023
Termination Date
Termination Reason
7/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
St. Elizabeth Healthcare
Lori Ritchey-Baldwin, CFO
(859) 655-1642
Primary Contact
St. Elizabeth Healthcare
Joe Thamann, Director of Reimbursement
(859) 655-1889
Addresses
Street Address
85 NORTH GRAND AVENUE
FT. THOMAS, KY 41075-1793
Billing Address
St. Elizabeth Healthcare
1 Medical Village Dr.
Edgewood, KY 41017
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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