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DSH110034L AU Medical Center, Inc. (Active)
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Main Details
Name
AU Medical Center, Inc.
Subdivision Name
Georgia Cancer Center - Downtown Augusta
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH110034L
Medicare Provider Number
110034
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/8/2019
Participating Start Date
1/1/2020
Participating Approval Date
11/24/2019
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
AU Medical Center, Inc.
Jennifer Moore Miller, VP, Strategy and Business Development
(706) 721-5250
Primary Contact
AU Medical Center, Inc.
Gerard Schick, Business Operations and 340B Manager
(706) 721-3979
Addresses
Street Address
818 SAINT SEBASTIAN WAY
STE 400
AUGUSTA, GA 30901-2654
Billing Address
AU Medical Center, Inc.
1120 15th Street
Augusta, GA 30912
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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