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DSH100088T BAPTIST MEDICAL CENTER (Active)
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Main Details
Name
BAPTIST MEDICAL CENTER
Subdivision Name
Baptist Clay-Diagnostic Radiology
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100088T
Medicare Provider Number
100088
Outpatient Facility Provider Number
100088
Additional Details
Current Program Status
Active
Registration Date
5/6/2024
Participating Start Date
7/1/2024
Participating Approval Date
6/11/2024
Last Recertification Date
8/26/2024
Contacts
Authorizing Official
Baptist Medical Center
Scott Finnegan, Senior Vice President of Finance/Treasury
(904) 202-3270
Primary Contact
Baptist Medical Center
Pamela Michelle Johnston, Sr 340B Pharmacy Specialist
(904) 202-5255
Addresses
Street Address
1771 Baptist Clay Drive
Fleming Island, FL 32003
Billing Address
Baptist Medical Center
PO BOX 45128
Jacksonville, FL 32232
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 10/01/2014; Terminated 7/1/2015; Reinstated 7/1/2024.
06/03/2024
April 2025
April 2025
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