340B Drug Pricing Program Database
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SCH110002-01 Upson County Hospital, Inc. (Active)
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Main Details
Name
Upson County Hospital, Inc.
Subdivision Name
UPSON REGIONAL MED CENTER CLINIC - Rural Health Clinic
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH110002-01
Medicare Provider Number
110002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/3/2019
Participating Start Date
1/1/2020
Participating Approval Date
11/24/2019
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Upson Regional Medical Center
John H Williams, CFO/COO
(706) 647-8111 Ext: 1117
Primary Contact
Upson Regional Medical Center
Joyce H Glisson, Pharmacist
(706) 647-8111 Ext: 1157
Addresses
Street Address
206 CHEROKEE RD
THOMASTON, GA 30286-3402
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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