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DSH440059 COOKEVILLE REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
COOKEVILLE REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440059
Medicare Provider Number
440059
Additional Details
Current Program Status
Terminated
Registration Date
1/5/2023
Participating Start Date
4/1/2023
Participating Approval Date
2/14/2023
Last Recertification Date
8/22/2024
Termination Date
Termination Reason
1/1/2025
DSH percentage below statutory minimum
Contacts
Authorizing Official
Cookeville Regional Medical Center
Marilyn Buffy Key, CEO
(931) 783-2000 Ext: 2481
Primary Contact
Cookeville Regional Medical Center
Sheldon Coffman Hitchcock, Director of Pharmacy
(931) 783-4089
Addresses
Street Address
Cookeville Regional Medical Center
1 Medical Center Blvd
COOKEVILLE, TN 38501
Billing Address
Cookeville Regional Medical Center
1 Medical Center Blvd
Cookeville, TN 38501
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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