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SCH190088-04 SPRINGHILL MEDICAL CENTER - AMENDED (Terminated)
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Main Details
Name
SPRINGHILL MEDICAL CENTER - AMENDED
Subdivision Name
Butler Abshire Medical Clinic Rural Health Clinic - Rural Health Clinic
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH190088-04
Medicare Provider Number
190088
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/3/2019
Participating Start Date
10/1/2019
Participating Approval Date
9/9/2019
Last Recertification Date
8/26/2020
Termination Date
Termination Reason
7/1/2021
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
Springhill Medical Services, Inc
Michael G. Patronis, CEO
(318) 539-1001
Primary Contact
Springhill Medical Services
Peter Johnson, Chief of Pharmacy & Ancillary Services
(318) 539-1023
Addresses
Street Address
900 Frances Drive
Haynesville, LA 71038-6100
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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