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CH04901B East Georgia Healthcare Center, Inc. (Active)
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Main Details
Name
East Georgia Healthcare Center, Inc.
Subdivision Name
East Georgia Healthcare Center, Inc.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-034725
340B ID
CH04901B
Grant Number
H80CS00512
Additional Details
Current Program Status
Active
Registration Date
5/9/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/10/2022
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
East Georgia Healthcare Center
Jill Sorrells, CFO
(478) 237-6262 Ext: 01214
Primary Contact
East Georgia Healthcare Center
Sable Fleming, Patient Services Manager
(478) 206-3489
Addresses
Street Address
4357 East Louisiana Avenue
Soperton, GA 30457-3004
Billing Address
EAST GEORGIA HEALTHCARE CENTER, INC.
215 North Coleman Street
SWAINSBORO, GA 30401
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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Participating Start Date 4/1/2004, Termination Date 4/1/2022, Reinstatement 7/1/2022
05/10/2022
6/8/09 ADDR CHANGE (WAS 109 MARTIN LUTHER KING JR. DRIVE) 11/20/08 REMOVED MEDICAID NUMBER (WAS 00632376A)
06/08/2009
May 2025
May 2025
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