340B Drug Pricing Program Database
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DSH110007N PHOEBE PUTNEY MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
PHOEBE PUTNEY MEMORIAL HOSPITAL
Subdivision Name
Phoebe Rehabilitation of Ashburn
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110007N
Medicare Provider Number
110007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/9/2012
Participating Start Date
1/1/2013
Participating Approval Date
11/27/2012
Last Recertification Date
9/11/2019
Termination Date
Termination Reason
10/1/2020
Business decision by the Covered Entity
Contacts
Authorizing Official
Phoebe Putney Memorial Hospital
Brian Church, CFO & CAO
(229) 312-4066
Primary Contact
Phoebe Putney Health Systems
Torey Alaine Jones, 340B Program Pharmacy Manager
(229) 312-2177
Addresses
Street Address
354 E. Washington Ave
Ashburn, GA 31714-5248
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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