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DSH010029M EAST ALABAMA MEDICAL CENTER (Active)
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Main Details
Name
EAST ALABAMA MEDICAL CENTER
Subdivision Name
East Alabama Pulmonology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010029M
Medicare Provider Number
010029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/2/2018
Participating Start Date
4/1/2018
Participating Approval Date
1/9/2018
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
East Alabama Medical Center
SAM PRICE, CFO
(334) 528-1313
Primary Contact
East Alabama Medical Center
Dana Caypless, Manager of Purchasing and 340B Compliance
(334) 528-2565
Addresses
Street Address
2412 Village Professional Drive
Opelika, AL 36801
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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