340B Drug Pricing Program Database
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RRC010001-00 SOUTHEAST HEALTH MEDICAL CENTER (Active)
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Main Details
Name
SOUTHEAST HEALTH MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
Rural
Yes
340B ID
RRC010001-00
Medicare Provider Number
010001
Additional Details
Current Program Status
Active
Registration Date
1/14/2025
Participating Start Date
4/1/2025
Participating Approval Date
1/27/2025
Last Recertification Date
Contacts
Authorizing Official
Southeast Health Medical Center
Robert Derek Miller, Senior Vice President, CFO
(334) 793-8701
Primary Contact
Southeast Health
Jacey Cox, Director of Pharmacy
(334) 793-8113
Addresses
Street Address
1108 ROSS CLARK CIRCLE
DOTHAN, AL 36301
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participated starting 1/1/2024; Terminated 7/1/2024; Reinstated 4/1/2025.
01/21/2025
May 2025
May 2025
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