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SCH100090-00 FLAGLER HOSPITAL (Terminated)
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Main Details
Name
FLAGLER HOSPITAL
Subdivision Name
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH100090-00
Medicare Provider Number
100090
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2018
Participating Start Date
7/1/2018
Participating Approval Date
4/17/2018
Last Recertification Date
9/23/2019
Termination Date
Termination Reason
10/1/2020
DSH percentage below statutory minimum
Contacts
Authorizing Official
Flagler Hospital
Murray Sherwood Marsh, Jr., Chief Financial Officer
(904) 819-4400
Primary Contact
Flagler Hospital
Michael Lee Hall, Administrator, Pharmacy and Support Services
(904) 819-4321
Addresses
Street Address
400 HEALTH PARK BLVD
ST AUGUSTINE, FL 32086
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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