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RRC010039-21 HUNTSVILLE HOSPITAL (Terminated)
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Main Details
Name
HUNTSVILLE HOSPITAL
Subdivision Name
Madison - Endoscopy
Type
Rural Referral Center
Rural
Yes
340B ID
RRC010039-21
Medicare Provider Number
010039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
11/23/2020
Participating Start Date
12/1/2020
Participating Approval Date
11/24/2020
Last Recertification Date
Termination Date
Termination Reason
10/1/2021
Other
Contacts
Authorizing Official
Huntsville Hospital
Clinton Carter, CFO
(256) 265-8818
Primary Contact
Huntsville Hospital
Luona Wang, Business Manager of Pharmacy Services
(256) 265-6241
Addresses
Street Address
8375 Hwy 72 W
Madison, AL 35758
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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