340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH110095W TIFT REGIONAL HEALTH SYSTEM, INC (Approved)
Print
Main Details
Name
TIFT REGIONAL HEALTH SYSTEM, INC
Subdivision Name
Tift Primary Care at Southwell Medical Clinic - Primary Care
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110095W
Medicare Provider Number
110095
Outpatient Facility Provider Number
Additional Details
Current Program Status
Approved
Registration Date
4/14/2025
Participating Start Date
7/1/2025
Participating Approval Date
5/27/2025
Last Recertification Date
Contacts
Authorizing Official
Tift Regional Health System
Troy Buren Brooks, SVP/CFO
(229) 353-3397
Primary Contact
Tift Regional Health System, Inc.
Robert Evan Nix, Director of Pharmacy
(229) 353-6298
Addresses
Street Address
2225 Highway 41 North
Tifton, GA 31794
Billing Address
Tift Regional Medical Center
PO Box 747
Tifton, GA 31793
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session