340B Drug Pricing Program Database
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CAH101314-00 Doctors Memorial Hospital, Inc. (Active)
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Main Details
Name
Doctors Memorial Hospital, Inc.
Subdivision Name
Type
Critical Access Hospital
Rural
No
340B ID
CAH101314-00
Medicare Provider Number
101314
Additional Details
Current Program Status
Active
Registration Date
11/9/2023
Participating Start Date
11/16/2023
Participating Approval Date
11/16/2023
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
Doctors Memorial Hospital
Lauren Faison-Clark, CEO
(850) 584-0886
Primary Contact
Doctors Memorial Hospital
Bonnie Jean Ellison, Director of Pharmacy
(850) 584-0833
Addresses
Street Address
333 N BYRON BUTLER PKWY
Perry, FL 32347
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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