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DSH180069D TUG VALLEY ARH REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
TUG VALLEY ARH REGIONAL MEDICAL CENTER
Subdivision Name
TUG VALLEY MEDICAL ASSOCIATES - INTERNAL MEDICINE
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180069D
Medicare Provider Number
180069
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/6/2018
Participating Start Date
1/1/2019
Participating Approval Date
11/7/2018
Last Recertification Date
9/3/2024
Contacts
Authorizing Official
ARH
Maria Braman, Chief Medical Officer
(406) 465-8506
Primary Contact
Appalachian Regional Healthcare, Inc
Michael Herald, Associate Vice President of Pharmaceutical Services
(606) 438-1210
Addresses
Street Address
306 HOSPITAL DRIVE
Suite 102
SOUTH WILLIAMSON, KY 41503
Billing Address
Tug Valley ARH Regional Medical Center - Accounts Payable
200 Hospital Drive
South Williamson, KY 41503
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Initial start 1/1/2018, Termination 4/1/2018, Reinstate 1/1/2019
10/30/2018
May 2025
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