Covered Entity Details

DSH010029U EAST ALABAMA MEDICAL CENTER (Active) - information as of 4/25/2025 12:00:21 AM

Main Details

Name

EAST ALABAMA MEDICAL CENTER

Subdivision Name

EAST AL INFECTIOUS DISEASE - INFECTIOUS DISEASE

Type

Disproportionate Share Hospital

Rural

340B ID

DSH010029U

Medicare Provider Number

010029

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/11/2018

Participating Start Date

4/1/2018

Participating Approval Date

1/25/2018

Last Recertification Date

8/12/2024

Contacts

Authorizing Official

East Alabama Medical Center
SAM PRICE, CFO
(334) 528-1313

Primary Contact

East Alabama Medical Center
Dana Caypless, Manager of Purchasing and 340B Compliance
(334) 528-2565

Addresses

Street Address

2000 Pepperell Parkway
Opelika, AL 36801

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?
Yes

State	Medicaid Number	NPI Number
AL	HOS0029H	1154386431

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
DSH010029A	Child	DSH	EAST ALABAMA MEDICAL CENTER	MEDICAL ARTS DIAGNOSTICS	121 NORTH 20TH STREET, BUILDING 17	OPELIKA	AL	Terminated
DSH010029AA	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC - FREESTANDING EMERGENCY DEPT. - Free Standing ER	900 CAMP AUBURN ROAD	AUBURN	AL	Active
DSH010029AB	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC - NEUROLOGY - Neurology Clinic-Auburn	2375 CHAMPIONS BLVD	AUBURN	AL	Active
DSH010029AC	Child	DSH	EAST ALABAMA MEDICAL CENTER	Sleep Disorders Clinic of East Alabama - Sleep Center	121 N 20th St	Opelika	AL	Active
DSH010029C	Child	DSH	EAST ALABAMA MEDICAL CENTER	AUBURN DIAGNOSTIC IMAGING	900 Camp Auburn Road	AUBURN	AL	Active
DSH010029E	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC-Lanier-Rehab Services	4800 48th Street	Valley	AL	Terminated
DSH010029F	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC-Lanier/Laboratory	4800 48th Street	Valley	AL	Terminated
DSH010029G	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC-Lanier/Operating Room	4800 48th Street	Valley	AL	Terminated
DSH010029H	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC-Lanier/Radiology	4800 48th Street	Valley	AL	Terminated
DSH010029J	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC-Lanier/Emergency Services	4800 48th Street	Valley	AL	Terminated
DSH010029K	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC-Lanier/Sleep Services	4800 48th Street	Valley	AL	Terminated
DSH010029L	Child	DSH	EAST ALABAMA MEDICAL CENTER	Outpatient Cardiology Non-Invasive/Auburn	2375 CHAMPIONS BLVD	AUBURN	AL	Terminated
DSH010029M	Child	DSH	EAST ALABAMA MEDICAL CENTER	East Alabama Pulmonology	2412 Village Professional Drive	Opelika	AL	Active
DSH010029N	Child	DSH	EAST ALABAMA MEDICAL CENTER	E/R PHYSICIANS - EMERGENCY	900 Camp Auburn Road	Auburn	AL	Terminated
DSH010029P	Child	DSH	EAST ALABAMA MEDICAL CENTER	INFUSION CENTER - ONCOLOGY	2000 Pepperell Parkway	Opelika	AL	Active
DSH010029Q	Child	DSH	EAST ALABAMA MEDICAL CENTER	WOUND TREATMENT CENTER - SURGERY	2000 Pepperell Parkway	Opelika	AL	Active
DSH010029R	Child	DSH	EAST ALABAMA MEDICAL CENTER	MEDICAL ONCOLOGY - ONCOLOGY	2501 Village Professional Drive	Opelika	AL	Active
DSH010029S	Child	DSH	EAST ALABAMA MEDICAL CENTER	SURGERY CENTER - SURGERY	2000 Pepperell Parkway	Opelika	AL	Active
DSH010029T	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAST AL SURGICAL CLINIC - SURGERY	2000 Pepperell Parkway	Opelika	AL	Active
DSH010029U	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAST AL INFECTIOUS DISEASE - INFECTIOUS DISEASE	2000 Pepperell Parkway	Opelika	AL	Active
DSH010029V	Child	DSH	EAST ALABAMA MEDICAL CENTER	EMERGENCY - EMERGENCY MEDICINE	2000 Pepperell Parkway	Opelika	AL	Active
DSH010029W	Child	DSH	EAST ALABAMA MEDICAL CENTER	RADIATION THERAPY PHYSICIANS - ONCOLOGY	2501 Village Professional Drive	Opelika	AL	Active
DSH010029X	Child	DSH	EAST ALABAMA MEDICAL CENTER	ENDOCRINOLOGY AND METABOLISM OF EAS - ENDOCRINOLOGY AND METABOLISM OF EAST ALABAMA	2420 Village Professional Drive	OPELIKA	AL	Active
DSH010029Y	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC - BREAST HEALTH CENTER - Breast Health Services	900 CAMP AUBURN RD	AUBURN	AL	Active
DSH010029Z	Child	DSH	EAST ALABAMA MEDICAL CENTER	EAMC - EAH INTERNAL MEDICINE & LAB - Internal medicine residency continuity clinic	1527 PROFESSIONAL PKWY	AUBURN	AL	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	AO Change Request	Roberts, Barbara Ellen Alabama State ADAP Manager Alabama Dept of Public Health 3342066417	PRICE, SAM CFO East Alabama Medical Center 3345281313	12/20/2024 7:54 AM
Contacts	Authorizing Official	Update	AO Change Request	PRICE, SAM CFO East Alabama Medical Center 3345281313	Roberts, Barbara Ellen Alabama State ADAP Manager Alabama Dept of Public Health 3342066417	12/19/2024 2:16 PM
Details	Last Recertification Date	Update	Recertification	8/22/2023 12:22:36 PM	8/12/2024 11:09:03 AM	8/12/2024 11:09 AM
Details	Last Recertification Date	Update	Recertification	9/6/2022 4:19:59 PM	8/22/2023 12:22:36 PM	8/22/2023 12:22 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	HOS0029H (GA)		9/6/2022 4:19 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	HOS0029H (FL)		9/6/2022 4:19 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	HOS0029H (MS)		9/6/2022 4:19 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	HOS0029H (TN)		9/6/2022 4:19 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1154386431 (GA)		9/6/2022 4:19 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1154386431 (FL)		9/6/2022 4:19 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1154386431 (MS)		9/6/2022 4:19 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1154386431 (TN)		9/6/2022 4:19 PM
Details	Last Recertification Date	Update	Recertification	8/18/2021 3:49:22 PM	9/6/2022 4:19:59 PM	9/6/2022 4:19 PM
Details	Last Recertification Date	Update	Recertification	8/18/2020 4:27:55 PM	8/18/2021 3:49:22 PM	8/18/2021 3:49 PM
Addresses	Main Address	Update	Change Request	2412 Village Professional Drive Opelika, AL 36801	2000 Pepperell Parkway Opelika, AL 36801	7/27/2021 2:29 PM
Contacts	Primary Contact	Update	Change Request	Beams, Chuck EXECUTIVE DIRECTOR OF PHARMACY EAMC 3345283473	Caypless, Dana Manager of Purchasing and 340B Compliance East Alabama Medical Center 3345282565	7/27/2021 2:29 PM
Addresses	Main Address	Update	Change Request	2000 Pepperell Parkway Opelika, AL 36801	2412 Village Professional Drive Opelika, AL 36801	4/7/2021 7:31 AM
Contacts	Primary Contact	Update	Profile Change Request	Beams, Chuck DIRECTOR OF PHARMACY EAMC 3345282473	Beams, Chuck EXECUTIVE DIRECTOR OF PHARMACY EAMC 3345283473	2/18/2021 9:42 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	8/18/2020 5:14 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		HOS0029H	8/18/2020 5:14 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		FL	8/18/2020 5:14 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	8/18/2020 5:14 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		HOS0029H	8/18/2020 5:14 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MS	8/18/2020 5:14 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	8/18/2020 5:14 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		HOS0029H	8/18/2020 5:14 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		TN	8/18/2020 5:14 PM
Medicaid Billing	NPI: Number	Delete	Change Request	1073685483 (GA)		8/18/2020 5:14 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1154386431	8/18/2020 5:14 PM
Medicaid Billing	NPI: State	Insert	Change Request		GA	8/18/2020 5:14 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1154386431	8/18/2020 5:14 PM
Medicaid Billing	NPI: State	Insert	Change Request		FL	8/18/2020 5:14 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1154386431	8/18/2020 5:14 PM
Medicaid Billing	NPI: State	Insert	Change Request		MS	8/18/2020 5:14 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1154386431	8/18/2020 5:14 PM
Medicaid Billing	NPI: State	Insert	Change Request		TN	8/18/2020 5:14 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/18/2020 4:27 PM
Medicaid Billing	Medicaid: Number	Insert	Recertification		HOS0029H	8/18/2020 4:27 PM
Medicaid Billing	Medicaid: State	Insert	Recertification		GA	8/18/2020 4:27 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1154386431	8/18/2020 4:27 PM
Medicaid Billing	NPI: State	Insert	Recertification		AL	8/18/2020 4:27 PM
Medicaid Billing	NPI: Number	Insert	Recertification		1073685483	8/18/2020 4:27 PM
Medicaid Billing	NPI: State	Insert	Recertification		GA	8/18/2020 4:27 PM
Medicaid Billing	NPI: Number	Delete	Recertification	1154386431 ( )		8/18/2020 4:27 PM
Details	Last Recertification Date	Update	Recertification	8/23/2019 12:10:13 PM	8/18/2020 4:27:55 PM	8/18/2020 4:27 PM
Details	Last Recertification Date	Update	Recertification	8/15/2018 4:16:30 PM	8/23/2019 12:10:13 PM	8/23/2019 12:10 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	8/12/2019 3:28 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		HOS0029H	8/12/2019 3:28 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		AL	8/12/2019 3:28 PM
Details	Last Recertification Date	Update	Recertification		8/15/2018 4:16:30 PM	8/15/2018 4:16 PM
Details	State	Update		Approved	Active	4/1/2018 12:00 AM
Contacts	Signed By	Insert	New Registration		PRICE, SAM CFO East Alabama Medical Center 3345281313	1/25/2018 12:05 PM
Details	340B ID	Update	New Registration		DSH010029U	1/25/2018 12:05 PM
Details	Entity Subname	Update	New Registration	EAST AL INFECTIOUS DISEASE	EAST AL INFECTIOUS DISEASE - INFECTIOUS DISEASE	1/25/2018 12:05 PM
Dates	Participating Approval Date	Update	New Registration		1/25/2018 12:05:31 PM	1/25/2018 12:05 PM
Details	State	Update	New Registration	Pending	Approved	1/25/2018 12:05 PM
Dates	Signed By Date	Update	New Registration		1/12/2018 9:33:53 AM	1/25/2018 12:05 PM
Dates	Start Date	Update	New Registration		4/1/2018 12:00:00 AM	1/25/2018 12:05 PM
Addresses	Main Address	Insert	New Registration		2000 Pepperell Parkway Opelika, AL 36801	1/11/2018 9:35 AM
Medicaid Billing	NPI: Number	Insert	New Registration		1154386431	1/11/2018 9:35 AM
Contacts	Authorizing Official	Insert	New Registration		PRICE, SAM CFO East Alabama Medical Center 3345281313	1/11/2018 9:35 AM
Contacts	Primary Contact	Insert	New Registration		Beams, Chuck DIRECTOR OF PHARMACY EAMC 3345282473	1/11/2018 9:35 AM
Details	Last Recertification Date	Insert	New Registration			1/11/2018 9:35 AM
Details	Grant Number	Insert	New Registration			1/11/2018 9:35 AM
Details	340B ID	Insert	New Registration			1/11/2018 9:35 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/11/2018 9:35 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/11/2018 9:35 AM
Details	Medicare Provider Number	Insert	New Registration		010029	1/11/2018 9:35 AM
Details	Entity Name	Insert	New Registration		EAST ALABAMA MEDICAL CENTER	1/11/2018 9:35 AM
Details	Program Code	Insert	New Registration		DSH	1/11/2018 9:35 AM
Details	Entity Subname	Insert	New Registration		EAST AL INFECTIOUS DISEASE	1/11/2018 9:35 AM
Dates	Participating Approval Date	Insert	New Registration			1/11/2018 9:35 AM
Details	State	Insert	New Registration		Pending	1/11/2018 9:35 AM
Dates	Registration Date	Insert	New Registration		1/11/2018 9:35:04 AM	1/11/2018 9:35 AM
Dates	Signed By Date	Insert	New Registration			1/11/2018 9:35 AM
Dates	Start Date	Insert	New Registration			1/11/2018 9:35 AM
Terminations	Termination Comments	Insert	New Registration			1/11/2018 9:35 AM
Terminations	Termination Date	Insert	New Registration			1/11/2018 9:35 AM
Terminations	Termination Effective Date	Insert	New Registration			1/11/2018 9:35 AM
Terminations	Termination Reason	Insert	New Registration			1/11/2018 9:35 AM