Sentinel Security Life Insurance Company

Transcription

1 Sentinel Security Life Insurance Company Medicare Select Provider Network Sentinel Security Life SELECT plans are available in the following states: Arizona Colorado Kansas Louisiana Nebraska North Carolina Oklahoma Texas Utah This listing is inclusive of all hospitals available for your use as part of being in the Sentinel Security Life SELECT Provider Network. SENTINEL SECURITY LIFE INSURANCE COMPANY PO BOX SALT LAKE CITY, UTAH REV 06/23/2014

2 Medicare Select Provider Network CONTACT INSURANCE CARRIER TO VERIFY PROVIDER PARTICIPATION AT TIME OF SALE by State and County ALABAMA Calhoun Jacksonville Hospital 1701 South Pelham Rd Jacksonville AL Coffee Medical Center Enterprise 400 N Edwards St Enterprise AL Covington Andalusia Regional Hospital 849 S Three Notch St Andalusia AL Mizell Memorial Hospital 702 N Main St Opp AL Dale Dale Medical Center 100 Hospital Ave Ozark AL Etowah Gadsden Regional Medical Center 1007 Goodyear Blvd Gadsden AL Morgan Decatur General Hospital Th Ave Se Decatur AL Randolph Randolph Medical Center Highway 22 Roanoke AL Wedowee Hospital 209 Main St N Wedowee AL ARIZONA Apache Sage Memorial Hospital Hwy 264 Ganado AZ Maricopa Arizona Regional Medical Center 515 N Mesa Dr Mesa AZ Arizona Spine And Joint Hospital 4620 E Baseline Rd Mesa AZ Pima Carondelet Heart And Vascular Institute 4888 N Stone Ave Tucson AZ Carondelet St Marys Hospital 1601 W Saint Marys Rd Tucson AZ El Dorado Hospital 1400 N. Wilmot Tucson AZ Northwest Medical Center 6200 North La Cholla Blvd Tucson AZ Northwest Medical Center Ina Urgent Care 2945 W Ina Road Tucson AZ Northwest Medical Center Outpatient Therapy 2945 W Ina Road Tucson AZ Northwest Medical Center Rancho Vistoso Urgent Care North Oracle Road Tucson AZ Northwest Rancho Vistoso Imaging Services North Oracle Road Tucson AZ St Josephs Hospital Of Tucson 350 N Wilmot Rd Tucson AZ ARIZONA Pinal Arizona Regional Medical Center Apache J 2050 W Southern Ave Apache Junction AZ Page 1 of 21 Sentinel Medicare Select Provider Network 6/23/2014

3 ARKANSAS Arkansas Dewitt Hospital And Nursing Home 1641 S Whitehead Dr De Witt AR Benton Ozarks Community Hospital Of Gravette 1101 Jackson St Sw Gravette AR Craighead Nea Baptist Memorial Hospital 3024 Stadium Blvd Jonesboro AR Garland National Park Medical Center 1910 Malvern Avenue Hot Springs AR Lawrence Lawrence Memorial Hospital 1309 W Main St Walnut Ridge AR Little River Little River Memorial Hospital 451 W Locke St Ashdown AR Pulaski St Vincent Doctors Hospital 6101 St Vincent Circle Little Rock AR St Vincent Infirmary Medical Center 2 St. Vincent Circle Little Rock AR St Vincent Medical Center North 2215 Wildwood Ave. Sherwood AR CALIFORNIA Alameda City Of Alameda Health Care District 2070 Clinton Ave Alameda CA Eden Medical Center Lake Chabot Rd Castro Valley CA Laurel Grove Hospital Lake Chabot Rd Castro Valley CA San Leandro Hospital E 14Th St San Leandro CA Colusa Colusa Regional Medical Center 199 Webster St Colusa CA Fresno Coalinga Regional Medical Center 1191 Phelps Ave Coalinga CA Kingsburg District Hospital 1200 Smith St Kingsburg CA Sanger General Hospital 2558 Jensen Ave Sanger CA Imperial Palo Verde Hospital 250 N 1St St Blythe CA Kern Bakersfield Memorial Hospital Th St Bakersfield CA Good Samaritan Hospital 901 Olive Dr Bakersfield CA Los Angeles Beverly Hospital 309 W Beverly Blvd Montebello CA Brotman Medical Center 3828 Delmas Ter Culver City CA CALIFORNIA Los Angeles Coast Plaza Doctors Hospital Studebaker Rd Norwalk CA Covina Valley Community Hospital 845 N Lark Ellen Ave West Covina CA Doctors Hospital Of West Covina 725 S Orange Ave West Covina CA Miracle Mile Medical Center 6000 San Vicente Blvd Los Angeles CA Pacifica Hospital Of The Valley 9449 San Fernando Rd Sun Valley CA Silver Lake Medical Center 1711 W Temple St Los Angeles CA St Johns Hospital & Health Care Center Nd St Santa Monica CA Temple Community Hospital 235 N Hoover St Los Angeles CA USC University Hospital 1500 San Pablo St Los Angeles CA Orange Western Medical Center Anaheim 1025 S Anaheim Blvd Anaheim CA Western Medical Center Santa Ana 1001 N Tustin Ave Santa Ana CA Riverside San Gorgonio Memorial Hospital 600 N Highland Springs Ave Banning CA San Bernardino Doctors Hospital 5000 San Bernardino St Montclair CA Mountains Community Hospital Hospital Rd Lake Arrowhead CA Page 2 of 21 Sentinel Medicare Select Provider Network 6/23/2014

4 CALIFORNIA San Diego Fallbrook Hospital 624 E Elder St Fallbrook CA San Francisco UCSF Medical Center 505 Parnassus Ave San Francisco CA Santa Clara Stanford Medical Center 300 Pasteur Dr Stanford CA Stanislaus Oak Valley District Hospital 350 S Oak Ave Oakdale CA COLORADO Alamosa San Luis Valley Regional Medical Center 106 Blanca Ave Alamosa CO CONNECTICUTT Hartford Bradley Memorial Hospital And Health Cen 81 Meriden Ave Southington CT Page 3 of 21 Sentinel Medicare Select Provider Network 6/23/2014

5 District of Columbia District of Columbi Greater Southeast Community Hospital 1310 Southern Ave Se Washington DC Howard University Hospital 2041 Georgia Ave Nw Washington DC Specialty Hospital of Washington - Hadley 4601 Martin Luther King Jr Ave Washington DC FLORIDA Broward Broward Health Coral Springs 3000 Coral Hills Dr. Coral Springs FL Broward Health Imperial Point 6401 N. Federal Highway Fort Lauderdale FL Broward Health Medical Center 1600 S. Andrews Ave. Fort Lauderdale FL Broward Health North 201 East Sample Rd. Pompano Beach FL Charlotte Charlotte Regional Medical Ctr 809 E Marion Ave Punta Gorda FL Peace River Regional Medical Center 2500 Harbor Blvd Port Charlotte FL Citrus Citrus Memorial Hospital 502 W Highland Blvd Inverness FL Seven Rivers Regional Medical Center 6201 N Suncoast Blvd Crystal River FL Collier Physicians Regional - Collier 8300 Collier Blvd Naples FL Physicians Regional - Pine Ridge 6101 Pine Ridge Road Naples FL Duval Shands Jacksonville- Pavillion 580 W Eighth St Jacksonville FL Shands Jacksonville-Med. Ctr. 655 W Eighth St Jacksonville FL Hernando Brooksville Regional Hospital Cortez Blvd Brooksville FL FLORIDA Hernando Spring Hill Regional Hospital Quality Dr Spring Hill FL Hillsborough H Lee Moffitt Cancer Ctr & Rsrch. Ins Magnolia Dr Tampa FL South Florida Baptist Hospital 301 N Alexander St Plant City FL St Josephs Hospital 3001 W MLK Jr Blvd Tampa FL St Josephs Womens Hospital 3030 W MLK Jr Blvd Tampa FL Indian River Indian River Medical Center th Street Vero Beach FL Lee Lehigh Regional Medical Center 1500 Lee Blvd Lehigh Acres FL Manatee Lakewood Ranch Medical Center 8330 Lakewood Ranch Bradenton FL Manatee Memorial Hospital & Health System 206 Second Street East Bradenton FL Marion Munroe Regional Medical Ctr 1500 SW 1st Ave Ocala FL Miami-Dade Jackson Memorial Hospital 1611 Nw 12Th Ave Miami FL Jackson North Medical Center 160 Nw 170Th St North Miami Beach FL Jackson South Community Hospital 9333 Sw 152Nd St Miami FL Page 4 of 21 Sentinel Medicare Select Provider Network 6/23/2014

6 FLORIDA Miami-Dade Miami Jewish Home And Hospital 5200 Ne 2Nd Ave Miami FL Palm Springs General Hospital 1475 W 49Th St Hialeah FL Westchester General Hospital 2500 Sw 75Th Ave Miami FL Orange Health Central Hospital W Colonial Dr Ocoee FL Palm Beach Lakeside Medical Center Hooker Hwy Belle Glade FL Wellington Regional Medical Center Forest Hill Blvd Wellington FL Pasco Florida Hospital Zephyrhills 7050 Gall Blvd Zephyrhills FL Morton Plant North Bay Hospital 6600 Madison St New Port Richey FL Pinellas Bayfront Medical Ctr 701 6th St S St Petersburg FL Largo Medical Center - Indian Rocks Campus 2025 Indian Rocks Rd Largo FL Mease Countryside Hospital 3231 McMullen Booth Rd Safety Harbor FL Mease Dunedin Hospital 601 Main St Dunedin FL Morton Plant Healthcare 300 Pinellas Street Clearwater FL St Anthonys Hospital 1200 Seventh Ave N St Petersburg FL FLORIDA Polk Heart of Florida Regional Medical Ctr US Hwy. 27 N. Davenport FL Sarasota Venice Regional Medical Center 540 The Rialto Venice FL GEORGIA Chatham St Josephs Hospital Mercy Blvd Savannah GA Cherokee Northside Hospital Cherokee INC 201 Hospital Rd Canton GA Clayton Southern Regional Medical Center 11 Upper Riverdale Rd. SW Riverdale GA Cook Memorial Hospital Of Adel 706 N Parrish Ave Adel GA Fannin Fannin Regional Hospital 2855 Old Highway 5 Blue Ridge GA Fulton Kindred Hospital Atlanta 705 Juniper St NE Atlanta GA Shepherd Center 2020 Peachtree Rd NW Atlanta GA Greene Minnie G Boswell Memorial Hospital 1201 Siloam Rd Greensboro GA Jackson BJC Medical Center 70 Medical Center Dr Commerce GA Newton Newton General Hospital 5126 Hospital Dr NE Covington GA Page 5 of 21 Sentinel Medicare Select Provider Network 6/23/2014

7 IDAHO Ada Complex Care Hospital Of Idaho 2131 S Bonito Way Meridian ID ILLINOIS Christian Pana Community Hospital 101 E 9Th St Pana IL Cook Holy Family Medical Center 100 River Road Des Plaines IL Our Lady of Resurrection Medical Center 5645 W. Addison ST Chicago IL Resurrection Medical Center 7435 W. Talcott Ave Chicago IL Saint Joseph Health Centers & Hospital 2900 N. Lake Shore Drive Chicago IL St Elizabeths Hospital 1431 N. Claremont Ave Chicago IL St Francis Hospital 355 Ridge Ave Evanston IL St Mary of Nazareth Hospital Center 2233 W. Division St Chicago IL The University of Chicago Hospitals and Health System 5841 S. Maryland Avenue Chicago IL Westlake Community Hospital 1225 W. Lake St Melrose Park IL Fulton Graham Hospital 210 W Walnut St Canton IL La Salle Illinois Valley Community Hospital 925 West St Peru IL Lake Highland Park Hospital 777 Park Ave W Highland Park IL ILLINOIS Mercer Mercer County Hospital 409 Nw 9Th Ave Aledo IL Peoria Proctor Hospital 5409 N Knoxville Ave Peoria IL Saint Clair Kenneth Hall Regional Hospital Inc 129 N 8Th St East Saint Louis IL Touchette Regional Hospital 5900 Bond Ave East Saint Louis IL Williamson Heartland Regional Medical Center 3333 W Deyoung St Marion IL Winnebago OSF Saint Anthony Medical Center 5666 E State St Rockford IL Page 6 of 21 Sentinel Medicare Select Provider Network 6/23/2014

8 INDIANA Clark Clark Memorial Hospital 1220 Missouri Ave Jeffersonville IN Saint Catherine Regional Hospital 2200 Market St Charlestown IN Floyd Floyd Memorial Hospital And Health Serv 1850 State St New Albany IN Lawrence Bedford Regional Medical Center 2900 W 16th St Bedford IN Washington Washington County Memorial Hospital 911 N Shelby St Salem IN IOWA Delaware Regional Medical Center Of Ne Ia And Del 709 W Main St Manchester IA Polk Broadlawns Medical Center 1801 Hickman Rd Des Moines IA Scott Trinity At Terrace Park 4500 Utica Ridge Rd Bettendorf IA Story Story County Hospital 630 6Th St Nevada IA KANSAS Greenwood Greenwood County Hospital 100 W 16th St Eureka KS Johnson Heartland Spine and Specialty Hospital Nall Ave Overland Park KS Sedgwick Kansas Surgery and Recovery Center 2770 N Webb Rd Wichita KS Shawnee St Francis Hospital and Medical Center 1700 SW 7th St Topeka KS Page 7 of 21 Sentinel Medicare Select Provider Network 6/23/2014

9 KENTUCKY Bullitt Jewish Hospital Medical Center South 1903 W Hebron Ln Shepherdsville KY Caldwell Caldwell Medical Center 101 Hospital Dr Princeton KY Clay Manchester Memorial Hospital 210 Marie Langdon Dr Manchester KY Fayette UK Hospital Chandler Medical Ctr. 800 Rose Street Lexington KY Green Jane Todd Crawford Memorial Hospital 202 Milby St Greensburg KY Jefferson Frazier Rehab Institute 220 Abraham Flexner Way Louisville KY Frazier Rehab Institute East 4912 US Hwy 42, Suite 104 Louisville KY Frazier Rehab Institute Fern Valley 100 High Rise Dr. Louisville KY Frazier Rehab Institute Jeffersontown Taylorsville Rd. Suite 950 Louisville KY Frazier Rehab Institute Newburg 3430 Newburg Road Suite 111A Louisville KY Frazier Rehab Institute Southwest 4604 Greenwood Rd Louisville KY Jewish Hospital 217 E Chestnut St. Louisville KY Livingston Livingston Hospital and Healthcare Services 131 Hospital Dr Salem KY KENTUCKY Meade Frazier Rehab Institute Meade County 534 Fairway Dr. Brandenburg KY Owen New Horizons Medical Center 330 Roland Ave Owenton KY Shelby Jewish Hospital Shelbyville 727 Hospital Dr Shelbyville KY Taylor Taylor County Hospital 1700 Old Lebanon Rd Campbellsville KY LOUISIANA Acadia Acadia General Hospital 1305 Crowley Rayne Hwy Crowley LA Allen Allen Parish Hospital 108 N 6Th St Kinder LA Bossier CHRISTUS Schumpert Bossier 2105 Airline Drive Bossier City LA Caddo CHRISTUS Schumpert - St. Mary Place One St. Mary Place Shreveport LA CHRISTUS Schumpert Highland 1453 East Bert Kouns Shreveport LA Calcasieu CHRISTUS St Patrick Hospital 524 Dr. Michael Debakey Dr Lake Charles LA Concordia Riverland Medical Center 1700 E Wallace Blvd N Ferriday LA East Baton Rouge Integra Hospital Baton Rouge Llc 8000 Summa Ave Baton Rouge LA Evangeline Savoy Medical Center 801 Poinciana Ave Mamou LA Jefferson Doctors Hospital of Jefferson 4320 Houma Blvd. Metairie LA Ochsner Medical Center Kenner 180 W. Esplanade Ave Kenner LA Ochsner Medical Center West Bank 2500 Belle Chasse Hwy. Gretna LA Page 8 of 21 Sentinel Medicare Select Provider Network 6/23/2014

10 LOUISIANA Lafayette Lafayette General Medical Center 1214 Coolidge St Lafayette LA Lafayette General Surgical Center 1000 West Pinhook Rd Lafayette LA Rehabilitation Hospital of Acadiana 310 Youngsville Highway Lafayette LA Lincoln Green Clinic Surgical Hospital 1118 S Farmerville St Ruston LA Orleans Community Care Hospital 1421 General Taylor St New Orleans LA Methodist Hospital 5620 Read Blvd. New Orleans LA Ochsner Baptist Medical Center 2700 Napoleon Ave New Orleans LA Ouachita P & S Surgical Hospital 312 Grammont St Monroe LA St Francis Medical Center 309 Jackson St Monroe LA St Francis North Hospital 3421 Medical Park Dr Monroe LA Pointe Coupee Pointe Coupee General Hospital 2202 False River Dr New Roads LA Rapides CHRISTUS St. Frances Cabrini Hospital 3330 Masonic Drive Alexandria LA Red River CHRISTUS Coushatta Health Care Center 1635 Marvelle Street Coushatta LA LOUISIANA Saint Helena St Helena Parish Hospital Highway 43 North Greensburg LA Saint Landry Opelousas General Hospital 539 E. Prudhomme St Opelousas LA Saint Tammany Louisiana Heart Hospital Highway 434 Lacombe LA St John The Baptist River Parishes Hospital 500 Rue De Sante La Place LA St Martin St Martin Hospital 210 Champagne Blvd Breaux Bridge LA St Tammany Ochsner Medical Center - Northshore 100 Medical Center Dr Slidell LA Terrebonne Terrebonne General Medical Center 8166 Main St. Houma LA Vermilion Abrom Kaplan Memorial 1310 W 7th St Kaplan LA Washington Riverside Medical Center 1900 Main St Franklinton LA Webster Phc Minden Lp 1 Medical Plaza Pl Minden LA Springhill Medical Center 2001 Doctors Drive Springhill LA MASSACHUSETTS Essex Amesbury Hospital 24 Morrill Pl Amesbury MA North Shore Medical Center Union Campus 500 Lynnfield St Lynn MA Middlesex Saints Memorial Medical Center Hospital Dr Lowell MA Somerville Hospital 230 Highland Ave Somerville MA Norfolk Good Samaritan Medical Center Goddard Ca 909 Sumner St Stoughton MA Quincy Medical Center 114 Whitwell St Quincy MA Plymouth Caritas Good Samaritan Medical Center 235 N Pearl St Brockton MA Suffolk Faulkner Hospital 1153 Centre St Boston MA Lemuel Shattuck Hospital 170 Morton St Jamaica Plain MA Tufts New England Medical Center 800 Washington St Boston MA Worcester Clinton Hospital 201 Highland St Clinton MA Hubbard Regional Hospital 340 Thompson Rd Webster MA Page 9 of 21 Sentinel Medicare Select Provider Network 6/23/2014

11 MICHIGAN Allegan Borgess Pipp Hospital 411 Naomi St Plainwell MI Hillsdale Hillsdale Community Health Center 168 S Howell St Hillsdale MI Kalamazoo Borgess Medical Center 1521 Gull Rd Kalamazoo MI Macomb Kern Hospital Dequindre Rd Warren MI Muskegon Lifecare Hospitals Of Western Michigan 1700 Oak Ave Fl 3 Muskegon MI Wayne Garden City Hospital 6245 Inkster Rd Garden City MI St Mary Mercy Hospital Mile Rd Livonia MI MINNESOTA Hennepin North Memorial Medical Center 3300 Oakdale Ave N Robbinsdale MN MISSISSIPPI Claiborne Patients Choice Medical Center Of Claibo 123 Mccomb Ave Port Gibson MS Copiah Hardy Wilson Memorial Hospital 233 Magnolia St Hazlehurst MS Jones South Central Regional Medical Center 1220 Jefferson St Laurel MS Marion Marion General Hospital 1560 Sumrall Rd Columbia MS Pearl River Crosby Memorial Hospital 801 Goodyear Blvd Picayune MS Pearl River County Hospital & Nursing Home 305 W Moody St Poplarville MS Pike Beacham Memorial Hospital 205 N Cherry St Magnolia MS Simpson Simpson Community Healthcare Inc 1842 Simpson Highway 149 Mendenhall MS Walthall Walthall County General 100 Hospital Dr Tylertown MS Page 10 of 21 Sentinel Medicare Select Provider Network 6/23/2014

12 MISSOURI Barton Barton County Memorial Hospital 29 Nw 1St Ln Lamar MO Greene Ozarks Community Hospital 2828 N National Ave Springfield MO Jackson St Joseph Medical Center 1000 Carondelet Dr Kansas City MO Jasper Landmark Hospital Of Joplin 2040 W 32Nd St Joplin MO Mercy McCune-Brooks Hospital 3125 Dr. Russell Smith Way Carthage MO Newton Freeman Hospital East 932 East 34th St Joplin MO Freeman Hospital West 1102 West 32nd St Joplin MO Freeman Neosho Hospital 113 West Hickory St Neosho MO Ray Excelsior Springs Medical Ctr 1700 Rainbow Blvd Excelsior Springs MO Ray County Memorial Hospital 904 Wollard Blvd Richmond MO Ripley Ripley County Memorial Hospital 109 Plum St Doniphan MO St Louis Des Peres Hospital 2345 Dougherty Ferry Rd St Louis MO St Louis University Hospital 3635 Vista at Grand Blvd St Louis MO MONTANA Missoula Community Medical Center 2827 Fort Missoula Rd Missoula MT NEVADA Clark Desert Springs Hospital Medical Center 2075 East Flamingo Road Las Vegas NV Spring Valley Hospital Medical Center 5400 So. Rainbow Blvd. Las Vegas NV Summerlin Hospital Medical Center 657 Town Center Drive Las Vegas NV Valley Hospital Medical Center 620 Shadow Ln Las Vegas NV Washoe Saint Marys Regional Medical Center 235 West Sixth St Reno NV Page 11 of 21 Sentinel Medicare Select Provider Network 6/23/2014

13 NEW HAMPSHIRE Strafford Wentworth Douglass Hospital 789 Central Ave Dover NH 3820 NEW JERSEY Bergen Bergen Regional Medical Center 230 E Ridgewood Ave Paramus NJ Hudson Jersey City Medical Center 355 Grand St Jersey City NJ Meadowlands Hospital Medical Center 55 Meadowlands Pkwy Secaucus NJ Morris Kindred Hospital Morris County 400 W Blackwell St Dover NJ Passaic Kindred Hospital Wayne 224 Hamburg Tpke Wayne NJ Union Kindred Hospital Rahway 865 Stone St Rahway NJ Robert Wood Johnson University Hospital 865 Stone St Rahway NJ Warren St. Luke s Hospital Warren Campus 185 Roseberry Street Phillipsburg NJ NEW MEXICO Bernalillo Heart Hospital Of New Mexico Llc 504 Elm St Ne Albuquerque NM Page 12 of 21 Sentinel Medicare Select Provider Network 6/23/2014

14 NEW YORK Erie Sheehan Memorial Hospital 425 Michigan Ave Buffalo NY Kings Coney Island Hospital 2601 Ocean Pkwy Brooklyn NY Kings County Hospital Center 451 Clarkson Ave Brooklyn NY Victory Memorial Hospital Nd St Brooklyn NY Nassau Nassau University Medical Center 2201 Hempstead Tpke East Meadow NY New York Bellevue Hospital Center 462 1St Ave New York NY Queens Peninsula Hospital Center 5115 Beach Channel Dr Far Rockaway NY The Parkway Hospital Inc Th St Forest Hills NY Richmond Staten Island University Hospital - North Campus 475 Seaview Ave Staten Island NY Staten Island University Hospital - South Campus 375 Seguine Ave Staten Island NY Suffolk Brunswick Hospital Center Inc 366 Broadway Amityville NY Warren Glens Falls Hospital 100 Park St Glens Falls NY NEW YORK Westchester Mount Vernon Hospital 12 N 7Th Ave Mount Vernon NY NORTH CAROLINA Orange University of North Carolina Hospitals 101 Manning Dr Chapel Hill NC Rockingham Annie Penn Memorial Hospital 618 S Main St Reidsville NC Page 13 of 21 Sentinel Medicare Select Provider Network 6/23/2014

15 OHIO Allen Lima Memorial Hospital 1001 Bellefontaine Ave Lima OH Belmont East Ohio Regional Hospital 90 N Fourth St Martin's Ferry OH Butler Mercy Hospital of Fairfield 3000 Mack Rd Fairfield OH Clermont Mercy Hospital Clermont 3000 Hospital Dr Batavia OH Cuyahoga Lakewood Hospital Detroit Ave Lakewood OH Erie Firelands Regional Medical Center - Main Campus 1111 Hayes Ave Sandusky OH Firelands Regional Medical Ctr -S. Campus 1912 Hayes Ave Sandusky OH Fairfield Fairfield Medical Center 401 N Ewing St Lancaster OH Franklin Arthur G. James Cancer Hospital 300 W 10th Ave Columbus OH Ohio State University Hospital East 1492 E Broad St. Columbus OH Ohio State University Hospitals 410 W 10th Ave Columbus OH Richard G. Solove Research Institute 300 W 10th Ave Columbus OH OHIO Guernsey Southeastern Ohio Regional Medical Center 1341 N Clark St Cambridge OH Hamilton Mercy Franciscan Hospital-Mt Airy Campus 2446 Kipling Ave Cincinnati OH Mercy Franciscan Hospital-Western Hills Campus 3131 Queen City Ave Cincinnati OH Mercy Hospital Anderson 7500 State Rd Cincinnati OH Licking The Medical Center of Newark 2000 Tamarack Rd Newark OH Lorain Lorain Commty/St Josephs Reg. Hlth Ctr 3700 Kolbe Rd Lorain OH Lucas St Anne Mercy Hospital 3404 Sylvania Ave Toledo OH St Charles Mercy Hospital 2600 Navarre Ave Oregon OH St Vincents Mercy Health Center 2213 Cherry St Toledo OH Mahoning St Elizabeth Health Ctr 1044 Belmont Ave Youngstown OH Medina Lodi Community Hospital 225 Elyria St Lodi OH Stark Massillon Community Hospital 875 8th St NE Massillon OH OKLAHOMA Beckham Sayre Memorial Hospital 911 Hospital Dr Sayre OK Caddo Physicians Hospital In Anadarko 1002 E Central Blvd Anadarko OK Latimer Latimer County General Hospital 806 Highway 2 N Wilburton OK Mcintosh Epic Medical Center 1 Hospital Dr Eufaula OK Murray Arbuckle Memorial Hospital 2011 W Broadway Ave Sulphur OK Oklahoma Edmond Medical Ctr One South Bryant St Edmond OK Midwest Regional Medical Center 2825 Parklawn Drive Midwest City OK OU Medical Center 1200 N. Everett Dr Oklahoma City OK Presbyterian Tower Hospital 700 NE 13th St Oklahoma City OK Sequoyah Sequoyah Memorial Hospital And Homecare 213 E Redwood Ave Sallisaw OK Tulsa Hillcrest Medical Center 1120 S Utica Ave Tulsa OK Oklahoma State University Medical Center 744 W 9th St Tulsa OK Page 14 of 21 Sentinel Medicare Select Provider Network 6/23/2014

16 PENNSYLVANIA Bucks St. Luke s Emergency & Transport Services, Inc. 11th Street & Park Avenue Quakertown PA St. Luke s Quakertown Hospital 1021 Park Avenue Quakertown PA Warminster Hospital 225 Newton Rd Warminster PA Delaware Crozer-Chester Medical Center One Medical Center Boulevard Upland PA Crozer-Chester Medical Center - Community Hospital 2600 West Ninth Street Chester PA Crozer-Chester Medical Center - Crozer Health Pavilion 145 South Brinton Lake Road Glen Mills PA Crozer-Chester Medical Center - Media Medical Pavilion 200 State Street Media PA Crozer-Chester Medical Center - Springfield Hospital 190 West Sproul Road Springfield PA Crozer-Chester Medical Center Crozer Medical Plaza at Brinton Lake 300 Evergreen Avenue Glen Mills PA Crozer-Chester Medical Center Crozer Medical Plaza Regional Cancer Center at Brinton Lake 500 Evergreen Avenue Glen Mills PA Crozer-Chester Medical Center Springfield Pavilion 30 Lawrence Road Broomall PA Crozer-Chester Medical Center Taylor Hospital 175 East Chester Pike Ridley Park PA DCMH Pavilion 30 Lawrence Road Broomall PA PENNSYLVANIA Delaware DCMH Rehab 1500 Garrett Road Upper Darby PA Delaware County Memorial Hospital 501 North Lansdowne Avenue Drexel Hill PA Delaware County Memorial Hospital - MOB Wellness Center II 2010 West Sproul Road Chester Pike Springfield PA Taylor Hospital 175 East Chester Pike Ridley Park PA Lawrence Jameson Hospital 1211 Wilmington Rd New Castle PA Lehigh St. Luke's Hospital - Allentown Campus 1736 Hamilton Street Allentown PA Northampton St. Luke s HomeStar Services, LLC 77 South Commerce Way Bethlehem PA St. Luke s Hospital Anderson Campus 1872 Riverside Circle Easton PA St. Luke s Physician Group, Inc. 240 Union Station Bethlehem PA St. Luke's Hospital Bethlehem Campus 801 Ostrum Street Bethlehem PA Visiting Nurse Association of St. Luke s Home Health/Hospice, Inc Valley Center Parkway, Suite 200 Bethlehem PA Philadelphia Episcopal Hospital 100 E Lehigh Ave Philadelphia PA Graduate Hospital 1800 Lombard Street Philadelphia PA PENNSYLVANIA Philadelphia Hahnemann University Hospital Broad and Vine Streets Philadelphia PA St Christophers Hospital for Children Erie Avenue at Front Street Philadelphia PA Schuylkill St. Luke s Miners Memorial Hospital 360 West Ruddle Street Coaldale PA Westmoreland Westmoreland Hospital 532 W Pittsburgh St Greensburg PA Page 15 of 21 Sentinel Medicare Select Provider Network 6/23/2014

17 RHODE ISLAND Providence Roger Williams Medical Center 825 Chalkstone Ave Providence RI 2908 SOUTH CAROLINA Allendale Allendale County Hospital Highway 278 West Fairfax SC Edgefield Edgefield County Hospital 300 Ridge Medical Plaza Rd Edgefield SC Marlboro Marlboro Park Hospital 1138 Cheraw St Bennettsville SC SOUTH DAKOTA Yankton Lewis And Clark Specialty Hospital 2601 Fox Run Pkwy Yankton SD Page 16 of 21 Sentinel Medicare Select Provider Network 6/23/2014

18 TENNESSEE Bradley Skyridge Medical Center - Main Campus 2305 Chambliss Ave Nw Cleveland TN Skyridge Medical Center - Westside Campus 2800 Westside Dr Nw Cleveland TN Coffee Medical Center Of Manchester 481 Interstate Dr Manchester TN Davidson Vanderbilt University Medical Center nd Avenue S. Nashville TN Hardin Hardin Medical Center 935 Wayne Road Savanna TN Houston Patients Choice Medical Center Of Erin 5001 E Main St Erin TN Knox University of Tennessee Medical Center 1924 Alcoa Hwy Knoxville TN Scott Scott County Hospital Alberta St Oneida TN Shelby Delta Medical Center 3000 Getwell Rd Memphis TN Unicoi Unicoi Memorial Hospital 100 Greenway Cir Erwin TN TEXAS Anderson Palestine Regional Med. Ctr - E. Campus 2900 S Loop 256 Palestine TX Palestine Regional Med. Ctr-W. Campus 4000 S Loop 256 Palestine TX Andrews Permian Regional Medical Center 720 Hospital Dr Andrews TX Angelina Memorial Medical Center of East Texas 1201 Frank Lufkin TX Memorial Specialty Hospital 1201 Frank Lufkin TX Bee CHRISTUS Spohn Hospital Beeville 1500 E Houston St Beeville TX Bexar Christus Santa Rosa Hospital 519 W Houston St San Antonio TX Christus Santa Rosa Medical Ctr 2827 Babcock Rd San Antonio TX Christus Santa Rosa Rehab. Hospital 2827 Babcock Rd-1st Floor San Antonio TX Bowie Christus St Michael Health System 2600 Saint Michael Dr Texarkana TX Brazoria Sweeny Community Hospital 305 N Mckinney St Sweeny TX Brazos St Josephs Home Health 3030 E 29th St, Suite 108 Bryan TX St Josephs Regional Health Ctr 2801 Franciscan Dr Bryan TX TEXAS Brazos St Josephs Regional Rehabilitation Ctr 1600 Joseph Dr Bryan TX Burleson Burleson St Joseph Health Center 1101 Woodson Dr Caldwell TX Somerville Family Medicine Clinic 600 Avenue C Somerville TX St Joseph - Caldwell Family Med. Clinic 1103 Woodson Dr Caldwell TX Camp East Texas Medical Center Pittsburg 2701 Us Highway 271 N Pittsburg TX Cherokee Mother Frances Hospital - Jacksonville 2026 S. Jackson Jacksonville TX Collin Integra Hospital Plano Llc 2301 Marsh Ln Plano TX Colorado Rice Medical Center 600 South Austin Rd Eagle Lake TX Culberson Culberson Hospital District Eisenhower Road Fm 2185 Van Horn TX Dallas Pine Creek Medical Center 9032 Harry Hines Blvd Dallas TX Denton Atrium Medical Center At Corinth 3305 Corinth Pkwy Corinth TX El Paso East El Paso Physicians Medical Center L 1416 George Dieter Dr El Paso TX Page 17 of 21 Sentinel Medicare Select Provider Network 6/23/2014

19 TEXAS El Paso University Medical Center Of El Paso 4815 Alameda Ave El Paso TX Fort Bend Sugarland Rehabilitation Hospital 1325 Highway 6 Sugar Land TX Frio Community General Hospital 230 W Miller St Dilley TX Gaines Memorial Hospital 209 Nw 8Th St Seminole TX Gregg Allegiance Specialty Hospital of Kilgore 1612 S Henderson Blvd Kilgore TX Good Shepherd Medical Center 700 E Marshall Ave Longview TX Longview Regional Medical Center 2901 North 4th St Longview TX Grimes Grimes St Joseph Health Ctr 210 S Judson St Navasota TX Harris CHRISTUS St Catherine Health & Wellness Center 701 S Fry Road Katy TX CHRISTUS St John Hospital St John Drive Nassau Bay TX St Joseph Medical Center 1401 St Joseph Parkway Houston TX Hidalgo Edinburg Regional Medical Center 1102 W Trenton Edinburg TX TEXAS Hidalgo McAllen Medical Center 301 W Expwy 83 McAllen TX Hill Lake Whitney Medical Center 200 N San Jacinto St Whitney TX Houston East Texas Medical Center Crockett 1100 E Loop 304 Crockett TX Jackson Jackson Healthcare Center 1013 S Wells St Edna TX Jasper CHRISTUS Jasper Memorial Hospital 1275 Marvin Hancock Dr Jasper TX Jefferson CHRISTUS Hospital St Mary 3600 Gates Boulevard Port Arthur TX CHRISTUS Outpatient Center 3701 Highway 73 Port Arthur TX Memorial Hermann Baptist Beaumont Hosp College St Beaumont TX Jim Wells CHRISTUS Spohn Hospital Alice 2500 E. Main St. Alice TX Jones Anson General Hospital 101 Avenue J Anson TX Kleberg CHRISTUS Spohn Hospital Kleberg 1300 General Cavazos Blvd. Kingsville TX Knox Knox County Hospital District 701 Se 5Th St Knox City TX TEXAS Lee Burleson St Joseph Lexington Fam. Med Clinic 609 Main St Lexington TX Leon Powell Memorial Health Center 102 E Main Centerville TX St Joseph - Normangee Fam. Med. Clinic Highway 3 W, Main and 9th St Normangee TX Liberty Cleveland Regional Medical Center 300 E Crockett St Cleveland TX Lubbock University Medical Ctr 602 Indiana Ave Lubbock TX Madison J B Heath Family Health Center 100 W Cross St Madisonville TX Madison St Joseph Health Ctr 100 W Cross St Madisonville TX Matagorda Palacios Community Medical Center 311 Green Ave Palacios TX Mclennan Providence Health Center 6901 Medical Pkwy Waco TX Montague Bowie Memorial Hospital 705 E Greenwood Ave Bowie TX Nacogdoches Nacogdoches Medical Center 4920 NE Stallings Dr Nacogdoches TX Nueces CHRISTUS Spohn Hospital Corpus Christi - Memorial 2606 Hospital Blvd Corpus Christi TX Page 18 of 21 Sentinel Medicare Select Provider Network 6/23/2014

20 TEXAS Nueces CHRISTUS Spohn Hospital Corpus Christi - Shoreline 600 Elizabeth St Corpus Christi TX CHRISTUS Spohn Hospital Corpus Christi - South 5920 Saratoga Blvd Corpus Christi TX Corpus Christi Med. Ctr. Bay Area Surgery 7101 S Padre Island Dr Corpus Christi TX Corpus Christi Med. Ctr. The Heart Hospital 7002 Williams Dr Corpus Christi TX Corpus Christi Medical Center 7101 S Padre Island Dr Corpus Christi TX Doctors Regional Medical Center 3315 S Alameda St Corpus Christi TX Northwest Regional Hospital Northwest Blvd Corpus Christi TX Orange Mem. Hermann Baptist Orange Hospital 608 Strickland Orange TX Panola East Texas Medical Ctr - Carthage 409 W Cottage Rd Carthage TX Polk Memorial Medical Center - Livingston 1717 Hwy 59 Bypass Livingston TX Potter Baptist St Anthonys Health System - Baptist Campus 1600 Wallace Blvd Amarillo TX Baptist St Anthonys Health System - St Anthonys Campus 200 NW 7th Amarillo TX Physicians Surgical Hospital 7100 W 9th Amarillo TX TEXAS Potter Physicians Surgical Hospital Plum Creek Amarillo TX Robertson St Joseph - Franklin Family Medicine Clinic Gay St Franklin TX St Joseph - Hearne Family Medicine Clinic 709 Barton St Hearne TX San Augustine Memorial Medical Center - San Augustine 511 Hospital Street San Augustine TX San Patricio North Bay Hospital 1711 W Wheeler Ave Aransas Pass TX Shelby Shelby Regional Medical Center 602 Hurst St Center TX Smith Trinity Mother Frances Health Systems 800 E Dawson Tyler TX Tyler ContinueCARE Hospital 800 E. Dawson Tyler TX UT Health Center at Tyler US Hwy 271 Tyler TX Starr Starr County Memorial Hospital Farm Road 3167 Rio Grande TX Tom Green San Angelo Community Medical Center 3501 Knickerbocker Rd San Angelo TX Travis Austin Surgical Hospital 3003 Bee Cave Rd Austin TX TEXAS Winkler Winkler County Memorial Hospital 821 Jeffee Dr Kermit TX Wood East Texas Medical Center Wood County 117 N Winnsboro St Quitman TX Page 19 of 21 Sentinel Medicare Select Provider Network 6/23/2014

21 UTAH Davis Davis Hospital & Medical Center 1600 W Antelope Dr Layton UT Salt Lake Jordan Valley Hospital 3580 West 9000 South West Jordan UT Pioneer Valley Hospital 3460 South Pioneer Parkway West Valley City UT Salt Lake Regional Medical Center 1050 East South Temple Salt Lake City UT University of Utah Hospitals and Clinics 50 North Medical Drive Salt Lake City UT VIRGINIA Patrick RJ Reynolds Patrick County Memorial Hosp Jeb Stuart Hwy Stuart VA WASHINGTON Kittitas Kittitas Valley Community Hospital 603 S Chestnut St Ellensburg WA Pacific Willapa Harbor Hospital 800 Alder Street South Bend WA Page 20 of 21 Sentinel Medicare Select Provider Network 6/23/2014

22 WEST VIRGINIA Marion Fairmont General Hospital 1325 Locust Ave Fairmont WV Nicholas Richwood Area Community Hospital 75 Avenue B Richwood WV Ohio Ohio Valley Medical Center 2000 Eoff St Wheeling WV WISCONSIN Milwaukee Lifecare Hospitals Of Milwaukee 5000 W Chambers St Milwaukee WI Outagamie Appleton Medical Center 1818 N Meade St Appleton WI Washburn Indianhead Medical Center 113 4Th Avenue Shell Lake WI Winnebago Theda Clark Medical Center 130 2nd St Neenah WI Page 21 of 21 Sentinel Medicare Select Provider Network 6/23/2014