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DSH440048G BAPTIST MEM HOSPITAL MEMPHIS (Active)
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Main Details
Name
BAPTIST MEM HOSPITAL MEMPHIS
Subdivision Name
THE CENTER FOR URINARY AND PELVIC DISORDERS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440048G
Medicare Provider Number
440048
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/13/2017
Participating Start Date
7/1/2017
Participating Approval Date
4/28/2017
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Baptist Memorial Health Care Corporation
Cyndi Pittman, VP Financial Operations
(901) 227-8480
Primary Contact
Baptist Memorial Health Care Corp
Donna C Cox, Director 340B
(901) 227-5144
Addresses
Street Address
6215 HUMPHREYS BLVD
Suite 110
MEMPHIS, TN 38120-2367
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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