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DSH110038X JOHN D ARCHBOLD MEMORIAL HOSPITAL (Active)
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Main Details
Name
JOHN D ARCHBOLD MEMORIAL HOSPITAL
Subdivision Name
ARCHBOLD NORTHSIDE CENTER FOR CHANGE - Outpatient Psychiatry
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110038X
Medicare Provider Number
110038
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2024
Participating Start Date
7/1/2024
Participating Approval Date
5/1/2024
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
John D. Archbold Memorial Hospital
Greg S. Hembree, CFO
(229) 228-2853
Primary Contact
John D. Archbold Memorial Hospital
Chris Newman, Vice President, Clinical and Support Services
(229) 228-2771
Addresses
Street Address
401 OLD ALBANY RD
THOMASVILLE, GA 31792-4014
Billing Address
John D. Archbold Memorial Hospital, Inc.
920 Cairo Rd
Thomasville, GA 31792
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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