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CAH111314-02 LIFEBRITE COMMUNITY HOSPITAL OF EARL (Active)
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Main Details
Name
LIFEBRITE COMMUNITY HOSPITAL OF EARL
Subdivision Name
LIFEBRITE HOSPITAL GROUP OF EARLY COUNTY, LLC D/B/A LIFEBRITE FAMILY MEDICAL OF EARLY
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH111314-02
Medicare Provider Number
111314
Outpatient Facility Provider Number
118509
Additional Details
Current Program Status
Active
Registration Date
1/5/2024
Participating Start Date
4/1/2024
Participating Approval Date
1/16/2024
Last Recertification Date
8/12/2024
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
11045 COLUMBIA ST.
BLAKELY, GA 39823
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 9/27/2010, Termination Date 4/1/2018, Reinstatement 4/1/2024
01/11/2024
3/28/12 - Updated bill to (was P.O.BOX 1100)
03/28/2012
May 2025
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