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DSH010091 GROVE HILL MEMORIAL HOSPITAL (Active)
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Main Details
Name
GROVE HILL MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH010091
Medicare Provider Number
010091
Additional Details
Current Program Status
Active
Registration Date
10/11/2019
Participating Start Date
1/1/2020
Participating Approval Date
10/18/2019
Last Recertification Date
8/27/2024
Contacts
Authorizing Official
Grove Hill Memorial Hospital
Kenneth Larrimore, COO
(251) 275-3191
Primary Contact
Grove Hill Memorial Hospital
Allen H Jordan, Pharmacy Manager
(251) 275-3191
Addresses
Street Address
295 SOUTH JACKSON STREET
GROVE HILL, AL 36451
Billing Address
GROVE HILL MEMORIAL HOSPITAL
P.O. BOX 935
GROVE HILL, AL 36451
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2017, terminated 10/1/2019. Reinstated 1/1/2020.
10/18/2019
1-30-12 - contact person and authorizing official updated
01/30/2012
April 2025
April 2025
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