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DSH180009W KING'S DAUGHTERS MEDICAL CENTER (Terminated)
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Main Details
Name
KING'S DAUGHTERS MEDICAL CENTER
Subdivision Name
HOME HEALTH
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180009W
Medicare Provider Number
180009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/22/2017
Last Recertification Date
8/16/2021
Termination Date
Termination Reason
1/1/2022
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
King's Daughters Medical Center
Kristie Whitlatch, CEO
(606) 408-4401
Primary Contact
King's Daughters Medical Center
Debbie Bell, 340B Coordinator
(606) 408-9503
Addresses
Street Address
2025 Carter Avenue
Ashland, KY 41101
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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