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DSH010029X EAST ALABAMA MEDICAL CENTER (Active)
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Main Details
Name
EAST ALABAMA MEDICAL CENTER
Subdivision Name
ENDOCRINOLOGY AND METABOLISM OF EAS - ENDOCRINOLOGY AND METABOLISM OF EAST ALABAMA
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010029X
Medicare Provider Number
010029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/12/2019
Participating Start Date
10/1/2019
Participating Approval Date
7/23/2019
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
2420 Village Professional Drive
OPELIKA, AL 36801-4742
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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