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DSH100135AE TALLAHASSEE MEMORIAL HEALTHCARE, INC (Active)
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Main Details
Name
TALLAHASSEE MEMORIAL HEALTHCARE, INC
Subdivision Name
TMH Physician Partners - Heart Rhythm Clinic - Electrophysiology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100135AE
Medicare Provider Number
100135
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2021
Participating Start Date
1/1/2022
Participating Approval Date
10/27/2021
Last Recertification Date
9/6/2024
Contacts
Authorizing Official
Tallahassee Memorial HealthCare
Priscilla Needham, Chief Financial Officer
(850) 431-0630
Primary Contact
Tallahassee Memorial HealthCare
Louis Kynard, Director of Pharmacy
(850) 431-5030
Addresses
Street Address
2100 Centerville Road
Tallahassee, FL 32308
Billing Address
Tallahassee Memorial HealthCare
1300 Miccosukee Road
Tallahassee, FL 32308
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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