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DSH010029AB EAST ALABAMA MEDICAL CENTER (Active)
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Main Details
Name
EAST ALABAMA MEDICAL CENTER
Subdivision Name
EAMC - NEUROLOGY - Neurology Clinic-Auburn
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH010029AB
Medicare Provider Number
010029
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/6/2023
Participating Start Date
7/1/2023
Participating Approval Date
4/14/2023
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
East Alabama Medical Center
SAM PRICE, CFO
(334) 528-1313
Primary Contact
East Alabama Medical Center
Dana Caypless, Manager of Purchasing and 340B Compliance
(334) 528-2565
Addresses
Street Address
2375 CHAMPIONS BLVD
STE 102
AUBURN, AL 36830-6471
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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