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CAH111306-04 EFFINGHAM HEALTH SYSTEM (Active)
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Main Details
Name
EFFINGHAM HEALTH SYSTEM
Subdivision Name
Effingham Family Medicine at Guyton
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH111306-04
Medicare Provider Number
111306
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/15/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/8/2016
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
CAH111306-00
Fran Baker-Witt, CEO
(912) 754-3822
Primary Contact
Effingham Health System
Earnest Powell, Pharmacy Director
(912) 754-0422
Addresses
Street Address
3 Hidden Creek Drive
Guyton, GA 31312
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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