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DSH010029E EAST ALABAMA MEDICAL CENTER (Terminated)
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Main Details
Name
EAST ALABAMA MEDICAL CENTER
Subdivision Name
EAMC-Lanier-Rehab Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010029E
Medicare Provider Number
010029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/13/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/1/2014
Last Recertification Date
8/16/2016
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
East Alabama Medical Center
SAM PRICE, CFO
(334) 528-1313
Primary Contact
EAMC
Chuck Beams, EXECUTIVE DIRECTOR OF PHARMACY
(334) 528-3473
Addresses
Street Address
4800 48th Street
Valley, AL 36854
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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