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DSH010095A HALE COUNTY HOSPITAL (Active)
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Main Details
Name
HALE COUNTY HOSPITAL
Subdivision Name
HALE COUNTY HOSPITAL - Hale County Hospital Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010095A
Medicare Provider Number
010095
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/7/2022
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Hale County Hospital
Dianne Lolley, Controller
(205) 632-6569
Primary Contact
Hale County Hospital
Tracy Moore Fondren, Pharmacy Director
(334) 624-3024 Ext: 2019
Addresses
Street Address
508 GREENE ST
# 2
GREENSBORO, AL 36744-2316
Billing Address
Hale County Hospital
508 Greene Street
Greensboro, AL 36744
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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