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DSH010029L EAST ALABAMA MEDICAL CENTER (Terminated)
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Main Details
Name
EAST ALABAMA MEDICAL CENTER
Subdivision Name
Outpatient Cardiology Non-Invasive/Auburn
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010029L
Medicare Provider Number
010029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/16/2016
Last Recertification Date
8/18/2020
Termination Date
Termination Reason
7/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
East Alabama Medical Center
SAM PRICE, CFO
(334) 528-1313
Primary Contact
EAMC
Chuck Beams, EXECUTIVE DIRECTOR OF PHARMACY
(334) 528-3473
Addresses
Street Address
2375 CHAMPIONS BLVD
AUBURN, AL 36830-6471
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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