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SCH190088-05 SPRINGHILL MEDICAL CENTER - AMENDED (Terminated)
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Main Details
Name
SPRINGHILL MEDICAL CENTER - AMENDED
Subdivision Name
BRADLEY MEDICAL CLINIC - Rural Health Clinic
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH190088-05
Medicare Provider Number
190088
Outpatient Facility Provider Number
048521
Additional Details
Current Program Status
Terminated
Registration Date
10/8/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/4/2020
Last Recertification Date
8/18/2023
Termination Date
Termination Reason
1/1/2024
Site closure
Contacts
Authorizing Official
Springhill Medical Center
Pete Johnson, CEO
(318) 539-1002
Primary Contact
Springhill Medical Center
Kristin Cole, CNO
(318) 539-1004
Addresses
Street Address
409 WOODRUFF STREET
BRADLEY, AR 71826-8715
Billing Address
Springhill Medical Services, Inc
401 11th NE
Springhill, LA 71075
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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