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CAH111310-00 MEDICAL CENTER OF PEACH COUNTY (Active)
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Main Details
Name
MEDICAL CENTER OF PEACH COUNTY
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH111310-00
Medicare Provider Number
111310
Additional Details
Current Program Status
Active
Registration Date
7/1/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/21/2015
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
The Medical Center of Peach County
Laura T Gentry, CEO
(478) 654-2423
Primary Contact
The Medical Center of Peach County
Megan Chumbley, Director of Pharmacy
(478) 654-2114
Addresses
Street Address
1960 HIGHWAY 247 CONNECTOR
BYRON, GA 31008
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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7/21/15 Participated starting 8/11/2010, terminated 7/1/2012 due to the request of the hospital. Reinstated based on new registration submitted in July 2015.
07/21/2015
April 2025
April 2025
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