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RRC250009-00 MAGNOLIA REGIONAL HEALTH CENTER (Terminated)
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Main Details
Name
MAGNOLIA REGIONAL HEALTH CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC250009-00
Medicare Provider Number
250009
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/28/2017
Last Recertification Date
8/15/2024
Termination Date
Termination Reason
4/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Magnolia Regional Health Center
Stephen Ray Thames, CFO
(662) 293-7647
Primary Contact
Magnolia Regional Health Center
Natalie Sleeper, DIRECTOR OF PHARMACY
(662) 293-1309
Addresses
Street Address
611 ALCORN DRIVE
CORINTH, MS 38834
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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