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RRC010039-54 HUNTSVILLE HOSPITAL (Active)
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Main Details
Name
HUNTSVILLE HOSPITAL
Subdivision Name
THE HEART CENTER - Coumadin Clinic
Type
Rural Referral Center
Rural
Yes
340B ID
RRC010039-54
Medicare Provider Number
010039
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/9/2024
Participating Start Date
4/1/2024
Participating Approval Date
2/20/2024
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Huntsville Hospital
Clinton Carter, CFO
(256) 265-8818
Primary Contact
Huntsville Hospital
Luona Wang, Business Manager of Pharmacy Services
(256) 265-6241
Addresses
Street Address
930 FRANKLIN STREET SE
HUNTSVILLE, AL 35801-4421
Billing Address
Huntsville Hospital
101 Sivley Rd SW
Huntsville, AL 35801
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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