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DSH440151 Saint Thomas River Park Hospital, LLC d/b/a Ascension Saint Thomas River Park (Active)
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Main Details
Name
Saint Thomas River Park Hospital, LLC d/b/a Ascension Saint Thomas River Park
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440151
Medicare Provider Number
440151
Additional Details
Current Program Status
Active
Registration Date
1/12/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/15/2017
Last Recertification Date
9/5/2024
Contacts
Authorizing Official
Ascension Saint Thomas
Brandon M Williams, TN Ministry Market CFO Saint Thomas
(615) 284-6845
Primary Contact
Ascension Rx
Bridget Caito, 340b Program Manager
(248) 563-8931
Addresses
Street Address
1559 SPARTA ROAD
MCMINNVILLE, TN 37110
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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