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DSH250123 SINGING RIVER GULFPORT (Terminated)
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Main Details
Name
SINGING RIVER GULFPORT
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH250123
Medicare Provider Number
250123
Additional Details
Current Program Status
Terminated
Registration Date
1/18/2022
Participating Start Date
3/11/2022
Participating Approval Date
1/24/2022
Last Recertification Date
8/28/2024
Termination Date
Termination Reason
4/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Singing River Health System
Heath Allen Thompson, Administrator Ancillary Services
(228) 818-1191
Primary Contact
Singing River Health System
Lisa D Fratesi, Executive Director of Pharmacy
(662) 347-0066
Addresses
Street Address
15200 COMMUNITY ROAD
GULFPORT, MS 39503-5307
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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