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DSH110078T EMORY UNIVERSITY HOSPITAL MIDTOWN (Active)
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Main Details
Name
EMORY UNIVERSITY HOSPITAL MIDTOWN
Subdivision Name
Emory Heart and Vascular Imaging at Smyrna
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110078T
Medicare Provider Number
110078
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/9/2014
Participating Start Date
7/1/2014
Participating Approval Date
4/25/2014
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Emory Decatur, Emory Hillandale
Lisa Urbistondo, Vice President & CFO
(404) 501-5025
Primary Contact
Emory Healthcare
Sydney Kchao, Corporate Director of Pharmacy, Business Operations and Finance
(404) 686-2147
Addresses
Street Address
1060 Windy Hill Road
Smyrna, GA 30080
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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