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DSH110007AY PHOEBE PUTNEY MEMORIAL HOSPITAL (Active)
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Main Details
Name
PHOEBE PUTNEY MEMORIAL HOSPITAL
Subdivision Name
PPMH Radiation Oncology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110007AY
Medicare Provider Number
110007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/16/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/19/2024
Last Recertification Date
8/28/2024
Contacts
Authorizing Official
Phoebe Putney Memorial Hospital
Brian Church, CFO & CAO
(229) 312-4066
Primary Contact
Phoebe Putney Health Systems
Torey Alaine Jones, 340B Program Pharmacy Manager
(229) 312-2177
Addresses
Street Address
425 W 3RD AVE., STE 50
ALBANY, GA 31701-1955
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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