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DSH110023 AdventHealth Gordon (Terminated)
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Main Details
Name
AdventHealth Gordon
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110023
Medicare Provider Number
110023
Additional Details
Current Program Status
Terminated
Registration Date
2/29/2008
Participating Start Date
4/1/2008
Participating Approval Date
3/1/2008
Last Recertification Date
9/6/2023
Termination Date
Termination Reason
7/1/2024
Change of covered entity type
Contacts
Authorizing Official
Gordon Hospital
Steve Gotshall, CE-VP CFO AH
(706) 879-4710
Primary Contact
Adventhealth Hendersonville
Larry D Phillips, Director Supply Chain and 340B Pharmacy
(828) 681-2720
Addresses
Street Address
1035 RED BUD ROAD NE
CALHOUN, GA 30701
Billing Address
AdventHealth Gordon
c/o AdventHealth
902 Inspiration Ave
Suite 9100
Altamonte Springs, FL 32714
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/31/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
10/19/2009
May 2025
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