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DSH110226A DEKALB MEDICAL CENTER AT HILLANDALE - DBA EMORY HILLANDALE HOSPITAL (Active)
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Main Details
Name
DEKALB MEDICAL CENTER AT HILLANDALE - DBA EMORY HILLANDALE HOSPITAL
Subdivision Name
DeKalb Hillandale Radiation Oncology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110226A
Medicare Provider Number
110226
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/15/2016
Last Recertification Date
8/23/2024
Contacts
Authorizing Official
Emory Decatur, Emory Hillandale
Lisa Urbistondo, Vice President & CFO
(404) 501-5025
Primary Contact
Emory Healthcare
Sydney Kchao, Corporate Director of Pharmacy, Business Operations and Finance
(404) 686-2147
Addresses
Street Address
2745 DeKalb Medical Parkway
Lithonia, GA 30058
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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