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DSH250025 MONROE HEALTH SERVICES INC. (Active)
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Main Details
Name
MONROE HEALTH SERVICES INC.
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250025
Medicare Provider Number
250025
Additional Details
Current Program Status
Active
Registration Date
4/7/2021
Participating Start Date
7/1/2021
Participating Approval Date
5/4/2021
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
North Mississippi Medical Center
BRUCE J. TOPPIN, GENERAL COUNSEL, PRIVACY OFFICER & COPORATE SECRETARY
(662) 377-4229
Primary Contact
North Mississippi Medical Center
Patti Hawkins, Director
(662) 377-4731
Addresses
Street Address
1105 EARL FRYE BLVD
AMORY, MS 38821
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/1/2018, terminated 10/1/2019. Reinstated 7/1/2021.
05/04/2021
April 2025
April 2025
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