340B Drug Pricing Program Database
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DSH110007AZ PHOEBE PUTNEY MEMORIAL HOSPITAL (Active)
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Main Details
Name
PHOEBE PUTNEY MEMORIAL HOSPITAL
Subdivision Name
MEDICATION MANAGEMENT CLINIC - MMC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110007AZ
Medicare Provider Number
110007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/14/2025
Participating Start Date
4/1/2025
Participating Approval Date
1/29/2025
Last Recertification Date
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
2000 PALMYRA RD
ALBANY, GA 31701-1528
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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