340B Drug Pricing Program Database
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DSH100093P BAPTIST HOSPITAL (Terminated)
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Main Details
Name
BAPTIST HOSPITAL
Subdivision Name
BH AI Non-Surg SM HWC
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100093P
Medicare Provider Number
100093
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/10/2020
Participating Start Date
4/1/2020
Participating Approval Date
1/28/2020
Last Recertification Date
9/5/2023
Termination Date
Termination Reason
10/1/2024
Business decision by the Covered Entity
Contacts
Authorizing Official
Baptist Health Care
Andrew L. Terry, Vice President Revenue Management
(850) 469-7643
Primary Contact
BHC
Frederick Seelmann, Executive Director of Pharmacy
(850) 469-7567
Addresses
Street Address
125 Baptist Way
Pensacola, FL 32503
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Is the service changing and/or are there additional services being added?
09/25/2023
April 2025
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