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DSH110018D PIEDMONT NEWTON HOSPITAL, INC. (Active)
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Main Details
Name
PIEDMONT NEWTON HOSPITAL, INC.
Subdivision Name
Piedmont Newton Hospital Imaging Center - Outpatient Diagnostic Center - MRI
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110018D
Medicare Provider Number
110018
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/11/2019
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Piedmont Newton Hospital
Lindsey H. Petrini, Chief Executive Officer
(770) 787-9059
Primary Contact
Piedmont Newton Hospital
Leigh Wilson, Director of Pharmacy
(770) 385-4459
Addresses
Street Address
5207 Highway 278
Covington, GA 30014
Billing Address
Piedmont Newton Hospital
5126 HOSPITAL DRIVE NE
COVINGTON, GA 30014
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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