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DSH110007AG PHOEBE PUTNEY MEMORIAL HOSPITAL (Terminated)
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Main Details
Name
PHOEBE PUTNEY MEMORIAL HOSPITAL
Subdivision Name
Phoebe North / Respiratory Therapy
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110007AG
Medicare Provider Number
110007
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/7/2015
Participating Start Date
7/1/2015
Participating Approval Date
5/15/2015
Last Recertification Date
8/30/2016
Termination Date
Termination Reason
10/1/2016
Site closure
Contacts
Authorizing Official
Phoebe Putney Memorial Hospital
Brian Church, CFO & CAO
(229) 312-4066
Primary Contact
Phil Barfield, Pharmacy Manager
(229) 312-0117
Addresses
Street Address
2000 PALMYRA RD
ALBANY, GA 31701-1528
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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