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DSH180044Q PIKEVILLE MEDICAL CENTER, INC. (Active)
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Main Details
Name
PIKEVILLE MEDICAL CENTER, INC.
Subdivision Name
PIKEVILLE MEDICAL CENTER INC - Pikeville Medical Center South Williamson
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH180044Q
Medicare Provider Number
180044
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/14/2020
Participating Start Date
5/1/2020
Participating Approval Date
4/21/2020
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Pikeville Medical Center
MICHELLE HAGY, CFO
(606) 430-3519
Primary Contact
Pikeville Medical Center inc.
Marcus Conley, Assistant Chief Financial Officer
(606) 430-3509
Addresses
Street Address
285 SOUTHSIDE MALL RD
STE D5
SOUTH WILLIAMSON, KY 41503-3905
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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