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SCH450241-00 FAITH COMMUNITY HOSPITAL (Active)
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Main Details
Name
FAITH COMMUNITY HOSPITAL
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH450241-00
Medicare Provider Number
450241
Additional Details
Current Program Status
Active
Registration Date
10/10/2016
Participating Start Date
1/1/2017
Participating Approval Date
12/8/2016
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Faith Community Hospital
Kim Lee, COO
(940) 216-2225
Primary Contact
Faith Community Hospital
Valerie Monk, Controller
(940) 216-2297
Addresses
Street Address
215 Chisholm Trail
JACKSBORO, TX 76458
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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