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CH04137B Perry County Medical Center Inc (Active)
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Main Details
Name
Perry County Medical Center Inc
Subdivision Name
Three Rivers Community Health-Dental
Type
HRSA-Funded Health Center
Site ID
BPS-H80-028144
340B ID
CH04137B
Grant Number
H80CS00346
Additional Details
Current Program Status
Active
Registration Date
10/7/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/8/2021
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Perry County Medical Center, Inc.
PHILLIP TATUM, CEO
(931) 589-2104
Primary Contact
Perry County Medical Center, Inc.
Luke Cagle, CFO
(931) 589-2104
Addresses
Street Address
7723 Clearview Church Ln Ste 200
Lyles, TN 37098-1674
Billing Address
Perry County Medical Center, Inc.
P O Box 916
Linden, TN 37096
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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