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DSH110034C AU Medical Center, Inc. (Terminated)
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Main Details
Name
AU Medical Center, Inc.
Subdivision Name
Digestive Health Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110034C
Medicare Provider Number
110034
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/29/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/12/2014
Last Recertification Date
8/26/2022
Termination Date
Termination Reason
10/1/2022
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
AU Medical Center, Inc.
Jennifer Miller, Chief Strategy Officer
(706) 836-7051
Primary Contact
AU Medical Center, Inc
Gerard Kristopher Schick, Business Operations Manager
(706) 721-3979
Addresses
Street Address
1481 Laney Walker Boulevard
Augusta, GA 30912
Billing Address
AU Medical Center, Inc.
1120 15th Street
Augusta, GA 30912
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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