340B Drug Pricing Program Database
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DSH420086 PRISMA HEALTH BAPTIST HOSPITAL (Active)
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Main Details
Name
PRISMA HEALTH BAPTIST HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH420086
Medicare Provider Number
420086
Additional Details
Current Program Status
Active
Registration Date
5/31/2006
Participating Start Date
7/1/2006
Participating Approval Date
6/1/2006
Last Recertification Date
8/21/2024
Contacts
Authorizing Official
Prisma Health
William Anthony Jackson, Market CEO Midlands
(803) 389-6598
Primary Contact
Prisma Health
Abigail Bouknight, Manager 340B
(803) 920-3041
Addresses
Street Address
1333 Taylor Street
COLUMBIA, SC 29202
Billing Address
Prisma Health
PO Box 402121
Atlanta, GA 30384
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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3/27/12 UPDATED MAIN ADD (WAS TAYLOR AT MARION ST. COLUMBIA, SC 29220), ADDED BILL-TO ADD
03/27/2012
May 2025
May 2025
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