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DSH250040BA SINGING RIVER HEALTH SYSTEM (Terminated)
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Main Details
Name
SINGING RIVER HEALTH SYSTEM
Subdivision Name
Singing River - ENT Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH250040BA
Medicare Provider Number
250040
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/5/2023
Participating Start Date
10/1/2023
Participating Approval Date
8/1/2023
Last Recertification Date
Termination Date
Termination Reason
7/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Singing River Health System
Heath Allen Thompson, Administrator Ancillary Services
(228) 818-1191
Primary Contact
Singing River Health System
Lisa D Fratesi, Executive Director of Pharmacy
(662) 347-0066
Addresses
Street Address
3101 Denny Ave
Suite 210
Pascagoula, MS 39581
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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