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DSH110092 DODGE COUNTY HOSPITAL (Terminated)
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Main Details
Name
DODGE COUNTY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110092
Medicare Provider Number
110092
Additional Details
Current Program Status
Terminated
Registration Date
4/26/2006
Participating Start Date
7/1/2006
Participating Approval Date
4/26/2006
Last Recertification Date
8/31/2023
Termination Date
Termination Reason
4/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Dodge County Hospital
Jimmy LaDon Toole, CEO
(229) 403-9175
Primary Contact
Dodge County Hospital
Jan T Hamrick, CFO
(478) 448-4050
Addresses
Street Address
901 GRIFFIN AVE
EASTMAN, GA 31023
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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