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RRC100292-00 SACRED HEART HOSPITAL ON THE EMERALD (Active)
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Main Details
Name
SACRED HEART HOSPITAL ON THE EMERALD
Subdivision Name
Type
Rural Referral Center
Rural
No
340B ID
RRC100292-00
Medicare Provider Number
100292
Additional Details
Current Program Status
Active
Registration Date
10/9/2020
Participating Start Date
1/1/2021
Participating Approval Date
11/23/2020
Last Recertification Date
8/20/2024
Contacts
Authorizing Official
Sacred Heart Health System, Inc.
Susan Cornejo, Chief Operating Officer
(850) 416-6206
Primary Contact
Sacred Heart Health System, Inc.
Troy Russo, 340B Coordinator
(850) 416-2859
Addresses
Street Address
7800 US HIGHWAY 98 WEST
DESTIN, FL 32550
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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