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RRC110038-00 John D. Archbold Memorial Hospital, Inc. (Terminated)
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Main Details
Name
John D. Archbold Memorial Hospital, Inc.
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC110038-00
Medicare Provider Number
110038
Additional Details
Current Program Status
Terminated
Registration Date
10/14/2013
Participating Start Date
1/1/2014
Participating Approval Date
11/17/2013
Last Recertification Date
8/17/2015
Termination Date
Termination Reason
4/1/2016
Change of covered entity type
Contacts
Authorizing Official
CHARLES D. HIGHTOWER, CFO
(229) 228-2853
Primary Contact
John D. Archbold Memorial Hospital
Chris Newman, Vice President, Clinical and Support Services
(229) 228-2771
Addresses
Street Address
Gordon Avenue at Mimosa Drive
Thomasville, GA 31792
Billing Address
John D. Archbold Memorial Hospital, Inc
920 Cairo Road
Thomasville, GA 31792
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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