340B Drug Pricing Program Database
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DSH250099H GREENWOOD LEFLORE HOSPITAL (Terminated)
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Main Details
Name
GREENWOOD LEFLORE HOSPITAL
Subdivision Name
Greenwood Childrens Clinic - Peds
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250099H
Medicare Provider Number
250099
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2022
Participating Start Date
10/1/2022
Participating Approval Date
7/28/2022
Last Recertification Date
Termination Date
Termination Reason
1/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Greenwood Lefore Hospital
Dawne Holmes, CFO
(662) 459-7119
Primary Contact
Greenwood Leflore Hospital
Spencer Jennings, Director of Pharmacy
(662) 459-2633
Addresses
Street Address
1405 Strong Ave
Greenwood, MS 38930
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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