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DSH180009Z KING'S DAUGHTERS MEDICAL CENTER (Active)
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Main Details
Name
KING'S DAUGHTERS MEDICAL CENTER
Subdivision Name
KDMS GYNECOLOGY - GYNECOLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180009Z
Medicare Provider Number
180009
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/11/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/25/2018
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
King's Daughters Medical Center
Sara Marks, Interim CEO
(606) 408-4401
Primary Contact
King's Daughters Medical Center
Debbie Bell, 340B Coordinator
(606) 408-9503
Addresses
Street Address
2245 WINCHESTER AVENUE
SUITE 1
ASHLAND, KY 41101
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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