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CAH111314-00 LIFEBRITE COMMUNITY HOSPITAL OF EARL (Active)
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Main Details
Name
LIFEBRITE COMMUNITY HOSPITAL OF EARL
Subdivision Name
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH111314-00
Medicare Provider Number
111314
Additional Details
Current Program Status
Active
Registration Date
7/14/2023
Participating Start Date
10/1/2023
Participating Approval Date
9/27/2023
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
LifeBrite Hospital Group of Early, LLC
Morgan Dunn, CEO
(601) 382-6315
Primary Contact
LifeBrite Hospital Group of Early, LLC
Stacey Gale, Director of Pharmacy
(229) 723-4241 Ext: 1006
Addresses
Street Address
11740 COLUMBIA STREET
BLAKELY, GA 39823
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating from effective date: (09/27/2010) until terminated effective date: (04/1/2018), reinstatement effective date: (10/1/2023)
09/26/2023
Participating from effective date: (09/27/2010), until terminated effective date: (04/1/2018), reinstatement effective date: (10/1/2023)
08/15/2023
April 2025
April 2025
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