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DSH110191 PIEDMONT HENRY HOSPITAL INC. (Active)
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Main Details
Name
PIEDMONT HENRY HOSPITAL INC.
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110191
Medicare Provider Number
110191
Additional Details
Current Program Status
Active
Registration Date
2/2/2023
Participating Start Date
4/1/2023
Participating Approval Date
2/3/2023
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Piedmont Henry Hospital Inc.
Wesley James, CFO
(678) 604-1001
Primary Contact
Piedmont Henry Hospital, INC
Christopher Bridgers, Director of Pharmacy
(678) 604-5303
Addresses
Street Address
1133 EAGLES LANDING PARKWAY
STOCKBRIDGE, GA 30281
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 4/1/2011, Termination Date 1/1/2020, Reinstatement 4/1/2023
02/03/2023
3/11/11 ENTITY PARTICIPATING FROM 10/1/06 TO 4/1/07 NOT PARTICIPATING FROM 4/1/07 TO 3/31/11 12/19/11 change PC from Miller to Fowler JH
12/19/2011
3/11/11 ENTITY PARTICIPATING FROM 10/1/06 TO 4/1/07 NOT PARTICIPATING FROM 4/1/07 TO 3/31/11
04/04/2011
May 2025
May 2025
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