340B Drug Pricing Program Database
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DSH110095 TIFT REGIONAL HEALTH SYSTEM, INC (Active)
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Main Details
Name
TIFT REGIONAL HEALTH SYSTEM, INC
Subdivision Name
DBA TIFT REGIONAL MEDICAL CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110095
Medicare Provider Number
110095
Additional Details
Current Program Status
Active
Registration Date
4/14/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/14/2008
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Tift Regional Health System
Troy Buren Brooks, SVP/CFO
(229) 353-3397
Primary Contact
Tift Regional Health System, Inc.
Robert Evan Nix, Director of Pharmacy
(229) 353-6298
Addresses
Street Address
901 E. 18TH ST.
TIFTON, GA 31794
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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ORIG PART 12/1/92 TO 12/31/96, INELIG FOR 340B FROM 1/1/97 THRU 6/30/2004
04/14/2008
April 2025
April 2025
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