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SCH180038-17 OWENSBORO HEALTH INC (Terminated)
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Main Details
Name
OWENSBORO HEALTH INC
Subdivision Name
Owensboro Health Outpatient Imaging - CT Breckenridge - CT
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH180038-17
Medicare Provider Number
180038
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/16/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/30/2018
Last Recertification Date
9/4/2022
Termination Date
Termination Reason
10/1/2023
Change of covered entity type
Contacts
Authorizing Official
Owensboro Health Regional Hospital - Owensboro, KY
Russ Ranallo, Chief Financial Officer
(270) 685-7180
Primary Contact
Owensboro Health Regional Hospital
Jason Collins, Director of Pharmacy
(270) 417-6711
Addresses
Street Address
1000 B Breckenridge
Owensboro, KY 42303
Billing Address
Owensboro Health Regional Hospital
PO Box 20007
Owensboro, KY 42304
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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