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DSH040039 ARKANSAS METHODIST MEDICAL CENTER (Active)
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Main Details
Name
ARKANSAS METHODIST MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH040039
Medicare Provider Number
040039
Additional Details
Current Program Status
Active
Registration Date
10/12/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/24/2023
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Arkansas Methodist Medical Center
Staci J Williams, CFO
(870) 239-7105
Primary Contact
Arkansas Methodist Medical Center
Stan Carmack, Pharm.D.
(870) 239-7861
Addresses
Street Address
900 WEST KINGS HIGHWAY
PARAGOULD, AR 72450
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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