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CAH251306-00 PERRY COUNTY GENERAL HOSPITAL (Terminated)
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Main Details
Name
PERRY COUNTY GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH251306-00
Medicare Provider Number
251306
Additional Details
Current Program Status
Terminated
Registration Date
4/8/2022
Participating Start Date
7/1/2022
Participating Approval Date
4/15/2022
Last Recertification Date
8/15/2023
Termination Date
Termination Reason
4/1/2024
Loss of qualifying hospital status
Contacts
Authorizing Official
Forrest Health System
Vance Green, Vice President
(601) 288-2320
Primary Contact
Highland Community Hospital
Haley S Hayes, PharmD
(228) 216-5476
Addresses
Street Address
206 BAY AVENUE
RICHTON, MS 39476
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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