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DSH110018B PIEDMONT NEWTON HOSPITAL (Terminated)
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Main Details
Name
PIEDMONT NEWTON HOSPITAL
Subdivision Name
EAST ATLANTA HEMAOLOGY & ONCOLOGY
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110018B
Medicare Provider Number
110018
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/9/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/12/2013
Last Recertification Date
9/1/2016
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
Piedmont Healthcare Multiple Hospital Entities
John G. Miles, Vice President / CFO
(770) 400-2336
Primary Contact
dsh110018
ROBERT K. HALLIDAY, DIRECTOR OF PHARMACY
(770) 385-4459
Addresses
Street Address
10157 EAGLE DRIVE
COVINGTON, GA 30014
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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