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DSH180012L Baptist Health Hardin (Active)
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Main Details
Name
Baptist Health Hardin
Subdivision Name
HMH DIAB MGMT/HMH DISEASE MGMT - Diabetes
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH180012L
Medicare Provider Number
180012
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/8/2020
Participating Start Date
7/1/2020
Participating Approval Date
5/1/2020
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Baptist Health Hardin
Thomas Carrico, Chief Operating Officer
(270) 706-5321
Primary Contact
Baptist Health Hardin
Christopher Michael Diem, System 340B Director
(270) 979-3725
Addresses
Street Address
521 Robinbrooke Blvd
Elizabethtown, KY 42701
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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