Covered Entity Details

DSH110024M CANDLER HOSPITAL (Active) - information as of 5/27/2025 2:39:26 PM

Main Details

Name

CANDLER HOSPITAL

Subdivision Name

Candler Employee Clinic at The Landing - Primary Care

Type

Disproportionate Share Hospital

Rural

340B ID

DSH110024M

Medicare Provider Number

110024

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

12/19/2024

Participating Start Date

1/8/2025

Participating Approval Date

1/8/2025

Last Recertification Date

Contacts

Authorizing Official

Candler Hospital
PAUL P. HINCHEY, CEO
(912) 819-6901

Primary Contact

St. Joseph's/Candler
Tommy Harvey, Business Manager Pharmacy
(912) 819-8155

Addresses

Street Address

71 Green Island Road
Savannah, GA 31411

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH110024B	Child	DSH	CANDLER HOSPITAL	SJC South Carolina Cancer Specialists	45 Hospital Center Commons	Hilton Head Island	SC	Active
DSH110024C	Child	DSH	CANDLER HOSPITAL	CH Infusion HHI	100 Buckwalter Place Blvd.	Bluffton	SC	Active
DSH110024D	Child	DSH	CANDLER HOSPITAL	Center for Medication Management	5313 Paulsen Street	Savannah	GA	Active
DSH110024E	Child	DSH	CANDLER HOSPITAL	Center for Infusion Therapy	5356 Reynolds Street	Savannah	GA	Active
DSH110024F	Child	DSH	CANDLER HOSPITAL	Center for Oncology Infusion Sumitt 3rd flr	225 Candler Drive	Savannah	GA	Active
DSH110024G	Child	DSH	CANDLER HOSPITAL	Center for Oncology Infusion CANDLER 2nd flr	225 Candler Drive	Savannah	GA	Active
DSH110024H	Child	DSH	CANDLER HOSPITAL	CH Gastro - Gastroenterology	5354 Reynolds Street	Savannah	GA	Active
DSH110024J	Child	DSH	CANDLER HOSPITAL	CH Okatie Infusion - Infusion	300 New River Parkway	Hardeeville	SC	Active
DSH110024K	Child	DSH	CANDLER HOSPITAL	SJ/C ONCOLOGY INFUSION - Oncology	455 S MAIN ST	HINESVILLE	GA	Active
DSH110024L	Child	DSH	CANDLER HOSPITAL	SJ/C INFUSION SERVICES - PEMBROKE - Oncology Infusion	159 W RAILROAD ST	PEMBROKE	GA	Active
DSH110024M	Child	DSH	CANDLER HOSPITAL	Candler Employee Clinic at The Landing - Primary Care	71 Green Island Road	Savannah	GA	Active
DSH110024N	Child	DSH	CANDLER HOSPITAL	Candler Employee Clinic at Thomas & Hutton - Primary Care	50 Park of Commerce Way	Savannah	GA	Active
DSH110024P	Child	DSH	CANDLER HOSPITAL	Candler Employee Clinic at Colonial Oil - Primary Care	509 Foundation Drive	Garden City	GA	Active
DSH110024Q	Child	DSH	CANDLER HOSPITAL	Candler Employee Clinic at Georgia Ports - Primary Care	52 Main Street	Garden City	GA	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update	OPA Edit	Approved	Active	1/8/2025 2:10 PM
Dates	Start Date	Update	OPA Edit	4/1/2025 12:00:00 AM	1/8/2025 12:00:00 AM	1/8/2025 2:10 PM
Contacts	Signed By	Insert	New Registration		HINCHEY, PAUL P. CEO Candler Hospital 9128196901	1/8/2025 2:04 PM
Details	340B ID	Update	New Registration		DSH110024M	1/8/2025 2:04 PM
Details	Entity Subname	Update	New Registration	Candler Employee Clinic at The Landing	Candler Employee Clinic at The Landing - Primary Care	1/8/2025 2:04 PM
Dates	Participating Approval Date	Update	New Registration		1/8/2025 2:04:39 PM	1/8/2025 2:04 PM
Details	State	Update	New Registration	Pending	Approved	1/8/2025 2:04 PM
Dates	Signed By Date	Update	New Registration		1/3/2025 2:48:29 PM	1/8/2025 2:04 PM
Dates	Start Date	Update	New Registration		4/1/2025 12:00:00 AM	1/8/2025 2:04 PM
Addresses	Main Address	Insert	New Registration		71 Green Island Road Savannah, GA 31411	12/19/2024 3:59 PM
Contacts	Authorizing Official	Insert	New Registration		HINCHEY, PAUL P. CEO Candler Hospital 9128196901	12/19/2024 3:59 PM
Contacts	Primary Contact	Insert	New Registration		Harvey, Tommy Business Manager Pharmacy St. Joseph's/Candler 9128198155	12/19/2024 3:59 PM
Details	Assistance Received From Date	Insert	New Registration			12/19/2024 3:59 PM
Details	Assistance Received To Date	Insert	New Registration			12/19/2024 3:59 PM
Details	Last Recertification Date	Insert	New Registration			12/19/2024 3:59 PM
Details	Grant Number	Insert	New Registration			12/19/2024 3:59 PM
Details	340B ID	Insert	New Registration			12/19/2024 3:59 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			12/19/2024 3:59 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			12/19/2024 3:59 PM
Details	Medicare Provider Number	Insert	New Registration		110024	12/19/2024 3:59 PM
Details	Entity Name	Insert	New Registration		CANDLER HOSPITAL	12/19/2024 3:59 PM
Details	NOFO Number	Insert	New Registration			12/19/2024 3:59 PM
Details	Program Code	Insert	New Registration		DSH	12/19/2024 3:59 PM
Details	Entity Subname	Insert	New Registration		Candler Employee Clinic at The Landing	12/19/2024 3:59 PM
Dates	Participating Approval Date	Insert	New Registration			12/19/2024 3:59 PM
Details	State	Insert	New Registration		Pending	12/19/2024 3:59 PM
Dates	Registration Date	Insert	New Registration		12/19/2024 3:59:01 PM	12/19/2024 3:59 PM
Dates	Signed By Date	Insert	New Registration			12/19/2024 3:59 PM
Dates	Start Date	Insert	New Registration			12/19/2024 3:59 PM
Terminations	Termination Comments	Insert	New Registration			12/19/2024 3:59 PM
Terminations	Termination Date	Insert	New Registration			12/19/2024 3:59 PM
Terminations	Termination Effective Date	Insert	New Registration			12/19/2024 3:59 PM
Terminations	Termination Reason	Insert	New Registration			12/19/2024 3:59 PM