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DSH110229G Piedmont Newnan Hospital, Inc. (Terminated)
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Main Details
Name
Piedmont Newnan Hospital, Inc.
Subdivision Name
RADIOLOGY ONCOLOGY SERVICES
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110229G
Medicare Provider Number
110229
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/15/2015
Participating Start Date
4/1/2015
Participating Approval Date
3/12/2015
Last Recertification Date
9/3/2019
Termination Date
Termination Reason
1/1/2020
DSH percentage below statutory minimum
Contacts
Authorizing Official
Piedmont Healthcare Multiple Hospital Entities
John G. Miles, Vice President / CFO
(770) 400-2336
Primary Contact
Piedmont Newnan Hospital
David Copelan, Director of Pharmacy
(770) 400-2460
Addresses
Street Address
775 Poplar Road
LL10
NEWNAN, GA 30265
Billing Address
Piedmont Newnan Hospital
745 Poplar Road
Newnan, GA 30265-1618
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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