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DSH010029AC EAST ALABAMA MEDICAL CENTER (Active)
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Main Details
Name
EAST ALABAMA MEDICAL CENTER
Subdivision Name
Sleep Disorders Clinic of East Alabama - Sleep Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010029AC
Medicare Provider Number
010029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/3/2024
Participating Start Date
10/1/2024
Participating Approval Date
7/12/2024
Last Recertification Date
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
121 N 20th St
Building 2
Opelika, AL 36801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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