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DSH010029A EAST ALABAMA MEDICAL CENTER (Terminated)
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Main Details
Name
EAST ALABAMA MEDICAL CENTER
Subdivision Name
MEDICAL ARTS DIAGNOSTICS
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010029A
Medicare Provider Number
010029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/3/2008
Participating Start Date
10/1/2004
Participating Approval Date
6/3/2008
Last Recertification Date
8/16/2016
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
East Alabama Medical Center
SAM PRICE, CFO
(334) 528-1313
Primary Contact
EAMC
Chuck Beams, EXECUTIVE DIRECTOR OF PHARMACY
(334) 528-3473
Addresses
Street Address
121 NORTH 20TH STREET, BUILDING 17
OPELIKA, AL 36801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/31/09 - DOC RECD TO CONFIRM ELIG DSH ADJ %
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