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RRC440012-00 BRISTOL REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
BRISTOL REGIONAL MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC440012-00
Medicare Provider Number
440012
Additional Details
Current Program Status
Active
Registration Date
4/14/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/3/2022
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Ballad Health
Shane Hilton, EVP, Chief Financial Officer
(423) 302-3467
Primary Contact
Ballad Health
Trish Tanner, VP, Chief Pharmacy Officer
(423) 302-3532
Addresses
Street Address
1 MEDICAL PARK BLVD
BRISTOL, TN 37620
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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