340B Drug Pricing Program Database
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DSH010023H BAPTIST MEDICAL CENTER SOUTH (Active)
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Main Details
Name
BAPTIST MEDICAL CENTER SOUTH
Subdivision Name
Crossbridge Intensive Outpatient Program - Psychiatry
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010023H
Medicare Provider Number
010023
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/3/2024
Participating Start Date
1/1/2025
Participating Approval Date
10/8/2024
Last Recertification Date
Contacts
Authorizing Official
Baptist Health
Walter Russell Tyner, Chief Executive Officer
(334) 747-4401
Primary Contact
Baptist Health
Amanda Stanford, System Director of Internal Audit
(334) 747-4449
Addresses
Street Address
4371 Narrow Lane Road, Suite 201
Montgomery, AL 36116
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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