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DSH440049DM METHODIST HEALTHCARE - MEMPHIS HOSPITALS (Active)
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Main Details
Name
METHODIST HEALTHCARE - MEMPHIS HOSPITALS
Subdivision Name
METHODIST HEALTHCARE - MEMPHIS HOSP - Emergency Department
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440049DM
Medicare Provider Number
440049
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/14/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/22/2016
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Methodist Healthcare - Memphis Hospitals
Chuck Lane, SVP/Associate CFO
(901) 516-0549
Primary Contact
Methodist Le Bonheur Healthcare
Chris Hilty, Director - Pharmacy Supply Chain
(901) 516-7570
Addresses
Street Address
8071 WINCHESTER ROAD SUITE 2
LEBONHEUR URGENT CARE - HACKS CROSS
MEMPHIS, TN 38125
Billing Address
Methodist Healthcare - Memphis Hospitals
P.O. Box 41058
Memphis, TN 38174
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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