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DSH110024P CANDLER HOSPITAL (Active)
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Main Details
Name
CANDLER HOSPITAL
Subdivision Name
Candler Employee Clinic at Colonial Oil - Primary Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110024P
Medicare Provider Number
110024
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
12/19/2024
Participating Start Date
1/8/2025
Participating Approval Date
1/8/2025
Last Recertification Date
Contacts
Authorizing Official
Candler Hospital
PAUL P. HINCHEY, CEO
(912) 819-6901
Primary Contact
St. Joseph's/Candler
Tommy Harvey, Business Manager Pharmacy
(912) 819-8155
Addresses
Street Address
509 Foundation Drive
Garden City, GA 31408
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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