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DSH110107C Atrium Health Navicent The Medical Center (Active)
Main Details
Name
Atrium Health Navicent The Medical Center
Subdivision Name
Atrium Health Navicent WT Anderson Infusion Center, a facility of Atrium Health Navicent The Medical Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110107C
Medicare Provider Number
110107
Outpatient Facility Provider Number
Contacts
Authorizing Official
Atrium Health
Don McCoy Mabe, Chief Pharmacy Officer
(704) 512-7623
Primary Contact
Atrium Health
Fern Paul-Aviles, AVP, Pharmacy
(704) 649-9691
Additional Details
Current Program Status
Active
Registration Date
9/7/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/17/2012
Last Recertification Date
9/7/2023
Addresses
Street Address
800 First Street
Suite 400
Macon, GA 31201
Billing Address
Medical Center of Central Georgia
777 Hemlock Street
MSC 113
Macon, GA 31201
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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