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CAH111327-02 BACON COUNTY HEALTH SERVICES, INC. D/B/A BACON COUNTY HOSPITAL AND HEALTH SYSTEM (Active)
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Main Details
Name
BACON COUNTY HEALTH SERVICES, INC. D/B/A BACON COUNTY HOSPITAL AND HEALTH SYSTEM
Subdivision Name
Rural Health Clinic II - NFHC
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH111327-02
Medicare Provider Number
111327
Outpatient Facility Provider Number
118560
Additional Details
Current Program Status
Active
Registration Date
7/1/2021
Participating Start Date
10/1/2021
Participating Approval Date
7/12/2021
Last Recertification Date
8/19/2024
Contacts
Authorizing Official
Bacon County Hospital and Health System
Kyle Lott, COO/ Pharmacy Director
(912) 632-3849
Primary Contact
Bacon County Hospital and Health System
Kade D Hutcheson, Pharmacy Supervisor
(912) 632-8961 Ext: 1018
Addresses
Street Address
1205 Van Streat Hwy
Nicholls, GA 31554
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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