340B Drug Pricing Program Database
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DSH110078AQ EMORY UNIVERSITY HOSPITAL MIDTOWN (Terminated)
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Main Details
Name
EMORY UNIVERSITY HOSPITAL MIDTOWN
Subdivision Name
EHM Smyrna / Respiratory
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110078AQ
Medicare Provider Number
110078
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
2/1/2017
Participating Start Date
4/1/2017
Participating Approval Date
2/21/2017
Last Recertification Date
9/5/2021
Termination Date
Termination Reason
1/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Emory
Greg E. Anderson, CFO
(404) 686-2823
Primary Contact
Emory Healthcare
Sydney Kchao, Corporate Director of Pharmacy, Business Operations and Finance
(404) 686-2147
Addresses
Street Address
3949 South Cobb Drive
Smyrna, GA 30080
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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