340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH110122G SOUTH GEORGIA MEDICAL CENTER (Active)
Print
Main Details
Name
SOUTH GEORGIA MEDICAL CENTER
Subdivision Name
SmithNorthview Hospital
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110122G
Medicare Provider Number
110122
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/10/2019
Participating Start Date
4/1/2019
Participating Approval Date
2/1/2019
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
SGMC
Ronald E Dean, CEO
(229) 259-4102
Primary Contact
SGMC
Scott Bruce Smith, Director of Pharmacy
(229) 259-4870
Addresses
Street Address
4280 North Valdosta Road
Valdosta, GA 31602
Billing Address
South Georgia Medical Center
2501 North Patterson St
Valdosta, GA 31601
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session