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DSH110038V JOHN D ARCHBOLD MEMORIAL HOSPITAL (Active)
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Main Details
Name
JOHN D ARCHBOLD MEMORIAL HOSPITAL
Subdivision Name
ARCHBOLD PHARMACOTHERAPY CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH110038V
Medicare Provider Number
110038
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/17/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/17/2023
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
John D. Archbold Memorial Hospital
Greg S. Hembree, CFO
(229) 228-2853
Primary Contact
John D. Archbold Memorial Hospital
Chris Newman, Vice President, Clinical and Support Services
(229) 228-2771
Addresses
Street Address
114 MIMOSA DR
Suite A
THOMASVILLE, GA 31792-6679
Billing Address
John D. Archbold Memorial Hospital, Inc.
920 Cairo Road
Thomasville, GA 31792
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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