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CAH041302-00 DARDANELLE HOSPITAL (Active)
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Main Details
Name
DARDANELLE HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH041302-00
Medicare Provider Number
041302
Additional Details
Current Program Status
Active
Registration Date
4/12/2021
Participating Start Date
4/28/2021
Participating Approval Date
4/27/2021
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Conway Regional Health System
James Reed, VP of Clinical Support Services/CIO
(501) 513-5152
Primary Contact
Conway Regional Medical Center
Josh Roberts, Pharmacy Director
(501) 513-5152
Addresses
Street Address
200 NORTH THIRD
DARDANELLE, AR 72834
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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