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DSH110122 SOUTH GEORGIA MEDICAL CENTER (Active)
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Main Details
Name
SOUTH GEORGIA MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110122
Medicare Provider Number
110122
Additional Details
Current Program Status
Active
Registration Date
4/15/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/15/2008
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
SGMC
Ronald E Dean, CEO
(229) 259-4102
Primary Contact
SGMC
Scott Bruce Smith, Director of Pharmacy
(229) 259-4870
Addresses
Street Address
2501 NORTH PATTERSON STREET
VALDOSTA, GA 31602
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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