340B Drug Pricing Program Database
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DSH110143B COBB HOSPITAL, INC. (Active)
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Main Details
Name
COBB HOSPITAL, INC.
Subdivision Name
Kennestone Cancer Center / Wellstar Cobb Infusion Therapy Tower
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110143B
Medicare Provider Number
110143
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/12/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/8/2016
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Wellstar Cobb Hospital
Felix Soto Izaguirre, Chief Financial Officer
(470) 732-5039
Primary Contact
Wellstar Health System
Sarah Oliver, 340B Program Director
(470) 956-4931
Addresses
Street Address
340 Kennestone Hospital Blvd Suite 100
Marietta, GA 30060-1158
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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