340B Drug Pricing Program Database
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DSH110091 Piedmont Rockdale Hospital, Inc. (Active)
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Main Details
Name
Piedmont Rockdale Hospital, Inc.
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110091
Medicare Provider Number
110091
Additional Details
Current Program Status
Active
Registration Date
1/14/2019
Participating Start Date
4/1/2019
Participating Approval Date
1/22/2019
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Piedmont Healthcare
Stewart Witherell, CFO
(770) 918-3101
Primary Contact
Piedmont Rockdale Hospital, Inc.
Amanda Meriwether Miller, Director of Pharmacy
(770) 918-3752
Addresses
Street Address
1412 Milstead Ave NE
CONYERS, GA 30012
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date (10/1/2006), until terminated effective date (4/1/2010), reinstatement effective date (04/01/2019)
01/16/2019
May 2025
May 2025
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