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DSH040118 NEA BAPTIST MEMORIAL HOSPITAL (ToBeTerminated)
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Main Details
Name
NEA BAPTIST MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040118
Medicare Provider Number
040118
Additional Details
Current Program Status
ToBeTerminated
Registration Date
4/14/2020
Participating Start Date
4/28/2020
Participating Approval Date
4/28/2020
Last Recertification Date
8/26/2024
Termination Date
Termination Reason
7/1/2025
Change of covered entity type
Contacts
Authorizing Official
Baptist Memorial Health Care Corporation
Cyndi Pittman, VP Financial Operations
(901) 227-8480
Primary Contact
Baptist Memorial Health Care Corp
Donna C Cox, Director 340B
(901) 227-5144
Addresses
Street Address
4800 EAST JOHNSON AVENUE
JONESBORO, AR 72405
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
April 2025
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