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DSH110034H AU Medical Center, Inc. (Active)
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Main Details
Name
AU Medical Center, Inc.
Subdivision Name
Cardiovascular Center 15th Street
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110034H
Medicare Provider Number
110034
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/6/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/13/2015
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
AU Medical Center, Inc.
Jennifer Moore Miller, VP, Strategy and Business Development
(706) 721-5250
Primary Contact
AU Medical Center, Inc.
Gerard Schick, Business Operations and 340B Manager
(706) 721-3979
Addresses
Street Address
937 15th Street
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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June 2025
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