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RRC490120-06 CHESAPEAKE GENERAL HOSPITAL (Terminated)
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Main Details
Name
CHESAPEAKE GENERAL HOSPITAL
Subdivision Name
Sleep Lab - Elizabeth City - Sleep Lab
Type
Rural Referral Center
Rural
Yes
340B ID
RRC490120-06
Medicare Provider Number
490120
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/13/2021
Participating Start Date
8/27/2021
Participating Approval Date
8/4/2021
Last Recertification Date
9/1/2022
Termination Date
Termination Reason
7/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Chesapeake General Hospital
Reese Jackson, President and CEO
(757) 312-8121
Primary Contact
Chesapeake General Hospital
Amy E Schultz, Director of Pharmacy
(757) 312-6168
Addresses
Street Address
1805 W City Drive
Elizabeth City, NC 27909
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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