340B Drug Pricing Program Database
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DSH180095 CRITTENDEN COUNTY HOSPITAL INC. (Terminated)
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Main Details
Name
CRITTENDEN COUNTY HOSPITAL INC.
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180095
Medicare Provider Number
180095
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2018
Participating Start Date
7/1/2018
Participating Approval Date
5/23/2018
Last Recertification Date
8/17/2018
Termination Date
Termination Reason
1/1/2019
Business decision by the Covered Entity
Contacts
Authorizing Official
Crittenden Health Systems
Daniel John Hiben, Chief Executive Officer
(270) 965-1018
Primary Contact
Crittenden Health System
Terry Wayne Nichols, VP
(573) 366-4892
Addresses
Street Address
520 W Gum St
MARION, KY 42064
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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