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SCH490018-04 AUGUSTA MEDICAL CENTER (Terminated)
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Main Details
Name
AUGUSTA MEDICAL CENTER
Subdivision Name
Augusta Health - Outpatient Physical Therapy
Type
Sole Community Hospital
Rural
Yes
340B ID
SCH490018-04
Medicare Provider Number
490018
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/5/2020
Participating Start Date
1/1/2021
Participating Approval Date
10/20/2020
Last Recertification Date
Termination Date
Termination Reason
10/1/2021
Other
Contacts
Authorizing Official
Augusta Health
Karen C Clark, Vice President of Operations
(540) 332-4800
Primary Contact
Augusta Health
Crystal L Lambert, Operations Manager
(540) 332-4596
Addresses
Street Address
107 Medical Center Drive
Fishersville, VA 22939
Billing Address
Augusta Health
78 Medical Center Drive
PO Box 1000
Fishersville, VA 22939
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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