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DSH010079B ATHENS-LIMESTONE (Terminated)
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Main Details
Name
ATHENS-LIMESTONE
Subdivision Name
ATHENS LIMESTONE SURGERY TOWER - OUTPATIENT SURGERY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010079B
Medicare Provider Number
010079
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2020
Participating Start Date
3/15/2022
Participating Approval Date
1/21/2020
Last Recertification Date
8/22/2023
Termination Date
Termination Reason
1/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Athens Limestone Hospital
JAMES R. COMER, CFO
(256) 233-9172
Primary Contact
Athens Limestone Hospital
Laura Garrie, Mgr. of Accounting
(256) 262-6468
Addresses
Street Address
22454 US HWY 72
ATHENS, AL 35613
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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