| Contacts | Primary Contact | Update | Group Change Request | Nowlin, Debbie
Director of Pharmacy
The Medical Center, Inc.
7066602757 | Crossman, Ryan R
Director of Pharmacy
Piedmont Columbus Regional
7065711503 | 10/4/2024 8:12 AM |
| Details | Last Recertification Date | Update | Recertification | 8/29/2023 2:34:20 PM | 8/26/2024 9:31:55 AM | 8/26/2024 9:31 AM |
| Details | Last Recertification Date | Update | Recertification | 8/30/2022 9:49:05 AM | 8/29/2023 2:34:20 PM | 8/29/2023 2:34 PM |
| Details | Last Recertification Date | Update | Recertification | 8/24/2021 2:01:27 PM | 8/30/2022 9:49:05 AM | 8/30/2022 9:49 AM |
| Details | Last Recertification Date | Update | Recertification | 8/21/2020 9:11:33 AM | 8/24/2021 2:01:27 PM | 8/24/2021 2:01 PM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1255401519 | 8/21/2020 9:11 AM |
| Medicaid Billing | NPI: State | Insert | Recertification | | GA | 8/21/2020 9:11 AM |
| Medicaid Billing | NPI: Number | Insert | Recertification | | 1255401519 | 8/21/2020 9:11 AM |
| Medicaid Billing | NPI: State | Insert | Recertification | | AL | 8/21/2020 9:11 AM |
| Medicaid Billing | NPI: Number | Delete | Recertification | 1255401519 ( ) | | 8/21/2020 9:11 AM |
| Details | Last Recertification Date | Update | Recertification | 9/6/2019 11:11:09 AM | 8/21/2020 9:11:33 AM | 8/21/2020 9:11 AM |
| Medicaid Billing | Medicaid: Number | Delete | Change Request | 913252000 (FL) | | 7/8/2020 2:25 PM |
| Addresses | Shipping Address | Delete | Change Request | Piedmont Columbus Regional Midtown - John B Amos Cancer Center
1831 5th Avenue
Columbus, GA 31904 | | 3/3/2020 11:30 AM |
| Addresses | Shipping Address | Insert | Change Request | | Regional Hope Pharmacy
1831 5th Avenue
Suite 150
Columbus, GA 31904 | 3/3/2020 11:30 AM |
| Addresses | Shipping Address | Insert | Change Request | | Piedmont Columbus Regional Midtown - John B Amos Cancer Center
1831 5th Avenue
Suite 150
Columbus, GA 31904 | 3/3/2020 11:30 AM |
| Addresses | Shipping Address | Delete | Change Request | Regional Hope Pharmacy
1831 5th Avenue
Columbus, GA 31904 | | 3/3/2020 11:30 AM |
| Details | Last Recertification Date | Update | Recertification | 9/5/2018 11:41:11 AM | 9/6/2019 11:11:09 AM | 9/6/2019 11:11 AM |
| Details | Entity Name | Update | Change Request | THE MEDICAL CENTER, INC. | THE MEDICAL CENTER, INC. dba Piedmont Columbus Regional Midtown | 4/4/2019 7:03 AM |
| Addresses | Shipping Address | Insert | Change Request | | Piedmont Columbus Regional Midtown - John B Amos Cancer Center
1831 5th Avenue
Columbus, GA 31904 | 3/19/2019 7:30 AM |
| Addresses | Billing Address | Update | Change Request | The Medical Center, Inc
710 Center Street
Columbus, GA 31901 | Piedmont Columbus Regional Midtown
710 Center Street
Columbus, GA 31901 | 3/19/2019 7:30 AM |
| Addresses | Shipping Address | Delete | Change Request | The Medical Center, Inc. JBACC location
1831 5th Avenue
Columbus, GA 31904 | | 3/19/2019 7:30 AM |
| Contacts | Authorizing Official | Update | Change Request | Hill, M. Scott
President and CEO
The Medical Center, Inc.
7066606103 | Hill, M. Scott
CEO
Piedmont Columbus Regional
7066606103 | 12/18/2018 1:02 PM |
| Contacts | Primary Contact | Update | Change Request | Nowlin, Debbie
Director Of Pharmacy
The Medical Center, Inc.
7065711495 | Nowlin, Debbie
Director of Pharmacy
The Medical Center, Inc.
7066602757 | 12/11/2018 7:12 PM |
| Details | Last Recertification Date | Update | Recertification | 11/15/2017 5:22:00 PM | 9/5/2018 11:41:11 AM | 9/5/2018 11:41 AM |
| Details | Last Recertification Date | Update | Recertification | 8/18/2016 12:00:00 AM | 11/15/2017 5:22:00 PM | 11/15/2017 5:22 PM |
| Contacts | Authorizing Official | Insert | Change Request | | Hill, M. Scott
President and CEO
The Medical Center, Inc.
7066606103 | 9/25/2017 7:52 AM |
| Contacts | Primary Contact | Update | | Nowlin, Debbie
Director Of Pharmacy
7065711495 | Nowlin, Debbie
Director Of Pharmacy
The Medical Center, Inc.
7065711495 | 9/19/2017 6:58 PM |
| Contacts | Primary Contact | Update | | Nowlin, Debbie
Associate Director of Pharmacy
7065711495 | Nowlin, Debbie
Director Of Pharmacy
7065711495 | 1/13/2017 1:12 PM |
| Addresses | Main Address | Insert | | |
1831 5TH AVENUE
COLUMBUS, GA 31904 | 11/9/2016 5:09 PM |
| Addresses | Billing Address | Insert | | | The Medical Center, Inc
710 Center Street
Columbus, GA 31901 | 11/9/2016 5:09 PM |
| Addresses | Shipping Address | Insert | | | Regional Hope Pharmacy
1831 5th Avenue
Columbus, GA 31904 | 11/9/2016 5:09 PM |
| Addresses | Shipping Address | Insert | | | The Medical Center, Inc. JBACC location
1831 5th Avenue
Columbus, GA 31904 | 11/9/2016 5:09 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 10/10/2016 9:54 AM |
| Medicaid Billing | Medicaid: Number | Insert | | | 913252000 | 10/10/2016 9:54 AM |
| Medicaid Billing | Medicaid: State | Insert | | | FL | 10/10/2016 9:54 AM |
| Details | Last Recertification Date | Update | | 8/24/2015 12:00:00 AM | 8/18/2016 12:00:00 AM | 8/18/2016 1:19 PM |
| Contacts | Primary Contact | Insert | | | Nowlin, Debbie
Associate Director of Pharmacy
7065711495 | 9/11/2015 4:07 PM |
| Details | Last Recertification Date | Update | | 8/28/2014 12:00:00 AM | 8/24/2015 12:00:00 AM | 8/24/2015 1:14 PM |
| Details | Entity Subname | Update | | JOHN B AMOS CANCER CENTER | JOHN B AMOS CANCER CENTER - Infusion | 8/24/2015 1:14 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 11/12/2014 12:56 PM |
| Medicaid Billing | Medicaid: Number | Insert | | | THE0064P | 11/12/2014 12:56 PM |
| Medicaid Billing | Medicaid: State | Insert | | | AL | 11/12/2014 12:56 PM |
| Details | Last Recertification Date | Update | | 9/9/2013 12:00:00 AM | 8/28/2014 12:00:00 AM | 8/28/2014 7:59 AM |
| Details | State | Update | | Terminated | Active | 3/31/2014 11:15 PM |
| Terminations | Termination Comments | Update | | Clinic Closed due to physician leaving practice | | 3/31/2014 11:15 PM |
| Terminations | Termination Date | Update | | 4/1/2014 12:00:00 AM | | 3/31/2014 11:15 PM |
| Terminations | Termination Reason | Update | | Site closure | | 3/31/2014 11:15 PM |
| Details | Comments Public | Insert | | | 03/31/2014: Termination recorded in error; site remained continuously eligible from participation start date.
2/23/12 Add NPI 4/5/06 - ADDED MED # | 3/31/2014 11:15 PM |
| Details | State | Update | | Active | Terminated | 3/31/2014 11:41 AM |
| Terminations | Termination Comments | Update | | | Clinic Closed due to physician leaving practice | 3/31/2014 11:41 AM |
| Terminations | Termination Date | Update | | | 4/1/2014 12:00:00 AM | 3/31/2014 11:41 AM |
| Terminations | Termination Reason | Update | | | Site closure | 3/31/2014 11:41 AM |
| Details | Last Recertification Date | Update | | 7/1/2012 12:00:00 AM | 9/9/2013 12:00:00 AM | 9/9/2013 10:05 PM |
| Medicaid Billing | Medicaid: Is Primary | Insert | | | False | 3/24/2013 8:45 AM |
| Medicaid Billing | Medicaid: Number | Insert | | | 000001196A | 3/24/2013 8:45 AM |
| Medicaid Billing | Medicaid: State | Insert | | | GA | 3/24/2013 8:45 AM |
| Details | Last Recertification Date | Update | | | 7/1/2012 12:00:00 AM | 5/14/2012 10:06 AM |
| Medicaid Billing | NPI: Number | Insert | | | 1255401519 | 4/11/2012 4:00 PM |
| Details | Entity Subname | Update | | REGIONAL HOPE PHARMACY | JOHN B AMOS CANCER CENTER | 4/11/2012 4:00 PM |
| Details | Entity Subname | Update | | JOHN B AMOS CANCER CENTER | REGIONAL HOPE PHARMACY | 4/14/2008 11:55 AM |
| Details | Last Recertification Date | Insert | | | | 4/14/2008 11:47 AM |
| Details | Grant Number | Insert | | | | 4/14/2008 11:47 AM |
| Details | 340B ID | Insert | | | DSH110064D | 4/14/2008 11:47 AM |
| Details | Is Authorizing Official EHB Data | Insert | | | | 4/14/2008 11:47 AM |
| Dates | Last Date That 340B Drugs Purchased | Insert | | | | 4/14/2008 11:47 AM |
| Details | Medicare Provider Number | Insert | | | 110064 | 4/14/2008 11:47 AM |
| Details | Entity Name | Insert | | | THE MEDICAL CENTER, INC. | 4/14/2008 11:47 AM |
| Details | Program Code | Insert | | | DSH | 4/14/2008 11:47 AM |
| Details | Entity Subname | Insert | | | JOHN B AMOS CANCER CENTER | 4/14/2008 11:47 AM |
| Dates | Participating Approval Date | Insert | | | 4/14/2008 12:00:00 AM | 4/14/2008 11:47 AM |
| Details | State | Insert | | | Active | 4/14/2008 11:47 AM |
| Dates | Registration Date | Insert | | | 4/14/2008 12:00:00 AM | 4/14/2008 11:47 AM |
| Dates | Signed By Date | Insert | | | | 4/14/2008 11:47 AM |
| Dates | Start Date | Insert | | | 4/1/2005 12:00:00 AM | 4/14/2008 11:47 AM |
| Terminations | Termination Comments | Insert | | | | 4/14/2008 11:47 AM |
| Terminations | Termination Date | Insert | | | | 4/14/2008 11:47 AM |
| Terminations | Termination Effective Date | Insert | | | | 4/14/2008 11:47 AM |
| Terminations | Termination Reason | Insert | | | | 4/14/2008 11:47 AM |
| Details | Comments Public | Insert | | | 2/23/12 Add NPI 4/5/06 - ADDED MED # | 4/14/2008 11:47 AM |
| Details | Comments Public | Insert | | | 4/5/06 - ADDED MED # | 4/14/2008 11:47 AM |