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CAH251309-04 FIELD MEMORIAL COMMUNITY HOSPITAL (Active)
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Main Details
Name
FIELD MEMORIAL COMMUNITY HOSPITAL
Subdivision Name
FMCH / LIBERTY CLINIC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH251309-04
Medicare Provider Number
251309
Outpatient Facility Provider Number
258610
Additional Details
Current Program Status
Active
Registration Date
10/12/2016
Participating Start Date
1/1/2017
Participating Approval Date
10/31/2016
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Field Memorial Community Hospital
Bernard Richard Williams, III, CEO/Administrator
(601) 890-0545
Primary Contact
Field Memorial Community Hospital
Vicki Anders, CFO
(601) 890-0546
Addresses
Street Address
1410 MAIN E ST
FMCH LIBERTY CLINIC
LIBERTY, MS 39645-0514
Billing Address
FMCH COMBINED CLINIC
178 Hwy. 24 East
Centreville, MS 39631
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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