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DSH180044H PIKEVILLE MEDICAL CENTER, INC. (Terminated)
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Main Details
Name
PIKEVILLE MEDICAL CENTER, INC.
Subdivision Name
PIKEVILLE MEDICAL CENTER INC - Bariatric Center
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180044H
Medicare Provider Number
180044
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/17/2017
Participating Start Date
10/1/2017
Participating Approval Date
7/24/2017
Last Recertification Date
8/20/2021
Termination Date
Termination Reason
10/1/2022
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
Pikeville Medical Center
MICHELLE HAGY, CFO
(606) 430-3519
Primary Contact
Pikeville Medical Center inc.
Marcus Conley, Assistant Chief Financial Officer
(606) 430-3509
Addresses
Street Address
1098 SOUTH MAYO TRAIL SUITE 103
PIKEVILLE, KY 41501
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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