Covered Entity Details

DSH340071 HARNETT HEALTH SYSTEM, INC. (Active) - information as of 4/27/2025 12:51:03 AM

Main Details

Name

HARNETT HEALTH SYSTEM, INC.

Subdivision Name

BETSY JOHNSON REGIONAL HOSPITAL

Type

Disproportionate Share Hospital

Rural

340B ID

DSH340071

Medicare Provider Number

340071

Additional Details

Current Program Status

Active

Registration Date

4/22/2008

Participating Start Date

10/1/2013

Participating Approval Date

9/15/2013

Last Recertification Date

8/13/2024

Contacts

Authorizing Official

Harnett Health System
Michael Tart, President
(910) 766-7102

Primary Contact

Harnett Health System
Amy Pope, Pharmacy Manager
(910) 766-7074

Addresses

Street Address

800 TILGHMAN DRIVE
DUNN, NC 28334

Billing Address

Harnett Health System
800 Tilghman Drive
PO Box 1706
Dunn, NC 28335

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
9/15/13 Enrolled 7/1/2008 and terminated 7/1/2013 at entity request. Ineligible from 7/1/2013 through 9/30/2013; reinstated effective 10/1/2013. 3/23/12 UPDATED ENTITY NAME (WAS BETSY JOHNSON REGIONAL HOSPITAL)	09/15/2013
4/9/13 - Per request of entity to terminate site from program participation. 3/23/12 UPDATED ENTITY NAME (WAS BETSY JOHNSON REGIONAL HOSPITAL)	04/09/2013
3/23/12 UPDATED ENTITY NAME (WAS BETSY JOHNSON REGIONAL HOSPITAL)	03/23/2012

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
NC	340071	1922144757
MD	451755500	1922144757
FL	009974800	1922144757
NM	24877719	1922144757
LA	3743973	1922144757

Shipping Addresses

Shipping Address 1

Harnett Health System
800 Tilghman Drive
Att: Pharmacy Department
Dunn, NC 28334

Shipping Address 2

Cape Fear Valley Lillington Pharmacy
225 Brightwater Drive
Suite 110
Lillington, NC 27546

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ADVANCED CARE SCRIPTS, INC	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	6251 CHANCELLOR DRIVE SUITE 101	ORLANDO	FL	32809	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK FLORIDA SPECIALTY PHARMACY LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7930 WOODLAND CENTER BLVD STE 500	TAMPA	FL	33614	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK ILLINOIS SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	800 BIERMANN CT STE B	MOUNT PROSPECT	IL	60056	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK KANSAS SPECIALTY PHARMACY	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	11162 RENNER BLVD	LENEXA	KS	66219	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK MASSACHUSETTS SPECIALTY PHARMAC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	25 BIRCH STREET, BLDG B, SUITE 100	MILFORD	MA	01757	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK MICHIGAN SPECIALTY PHARMACY, LL	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1307 ALLEN DR STE H	TROY	MI	48083	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK NEW JERSEY SPECIALTY PHCY, LLC	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	180 PASSAIC AVE UNIT B-5	FAIRFIELD	NJ	07004	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK NORTH CAROLINA SPECIALTY PHARMA	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	10700 WORLD TRADE BLVD STE 110	RALEIGH	NC	27617	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK TENNESSEE SPECIALTY PHARMACY, L	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	8370 WOLF LAKE DR STE 107	BARTLETT	TN	38133	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	1127 BRYN MAWR AVE SUITE A	REDLANDS	CA	92374	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CAREMARK, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	7251 S. EASTERN AVE.	LAS VEGAS	NV	89119	04/10/2025	07/01/2025		04/10/2025
Contract Detail	CVS/SPECIALTY OR CARELONRX SPECIALTY PHA	CAREMARK, LLC	1001 SPINKS ROAD, STE 280	FLOWER MOUND	TX	75028	04/10/2025	07/01/2025		04/10/2025
Contract Detail	ECKERD CORPORATION	RITE AID #11510	1721 WEST CUMBERLAND STREET	DUNN	NC	28334	10/15/2013	01/01/2014	07/31/2017	04/28/2017
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07597	803 SOUTH MAIN ST.	LILLINGTON	NC	27546	04/10/2025	07/01/2025		04/10/2025
Contract Detail	NORTH CAROLINA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07500	80 W. JACKSON BLVD.	ERWIN	NC	28339	04/10/2025	07/01/2025		04/10/2025
Contract Detail	PRESCOTT'S PHARMACIES	THE MEDICINE CENTER	1402 W CUMBERLAND ST 1402 WEST CUMBERLAND STREET	DUNN	NC	28334-2833	01/15/2014	04/01/2014	09/07/2018	09/07/2018
Contract Detail	PROCARE PHARMACY DIRECT, L.L.C.	DBA CVS/SPECIALTY OR CARELONRX SPECIALTY	105 MALL BOULEVARD	MONROEVILLE	PA	15146	04/10/2025	07/01/2025		04/10/2025
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA CVS/PHARMACY #2923	3250 HARDEN ST. EXT. SUITE #300	COLUMBIA	SC	29203	04/10/2025	07/01/2025		04/10/2025
Contract Detail	PROCARE PHARMACY, L.L.C.	DBA: CVS/PHARMACY #2909	1521 4TH AVE., SOUTH	BIRMINGHAM	AL	35233	04/10/2025	07/01/2025		04/10/2025
Contract Detail	THE PAVILION PHARMACY	6387 RAMSEY ST UNIT 130		FAYETTEVILLE	NC	28311	04/13/2020	07/01/2020		07/01/2020
Contract Detail	THOMAS DRUG STORE	609 E. CUMBERLAND STREET	P.O. BOX 245	DUNN	NC	28334	01/15/2014	04/01/2014	09/03/2018	09/03/2018

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH340071A	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Outpatient Cardiac Testing	803 Tilghman Drive	Dunn	NC	Terminated
DSH340071B	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Breast Cancer Center	700 Tilghman Drive	Dunn	NC	Active
DSH340071C	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Wound Care Center	803 Tilghman Drive	Dunn	NC	Active
DSH340071D	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Outpatient Rehabilitation	55 Bain Street	Lillington	NC	Active
DSH340071E	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Benson Rehabilitation and Wellness Center	#1 Medical Drive	Benson	NC	Terminated
DSH340071F	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Outpatient Observation	215 Brightwater Drive	Lillington	NC	Active
DSH340071G	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Emergency Department	215 Brightwater Drive	Lillington	NC	Active
DSH340071H	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Cardiopulmonary	215 Brightwater Drive	Lillington	NC	Active
DSH340071J	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Occupational Therapy	215 Brightwater Drive	Lillington	NC	Active
DSH340071K	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Speech Therapy	215 Brightwater Drive	Lillington	NC	Active
DSH340071L	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Physical Therapy	215 Brightwater Drive	Lillington	NC	Active
DSH340071M	Child	DSH	HARNETT HEALTH SYSTEM, INC.	CT	215 Brightwater Drive	Lillington	NC	Active
DSH340071N	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Mammography	215 Brightwater Drive	Lillington	NC	Active
DSH340071P	Child	DSH	HARNETT HEALTH SYSTEM, INC.	MRI	215 Brightwater Drive	Lillington	NC	Active
DSH340071Q	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Ultrasound	215 Brightwater Drive	Lillington	NC	Active
DSH340071R	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Radiology	215 Brightwater Drive	Lillington	NC	Active
DSH340071S	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Outpatient Surgery (Anesthesiology)	215 Brightwater Drive	Lillington	NC	Active
DSH340071T	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Outpatient Surgery (Recovery Room)	215 Brightwater Drive	Lillington	NC	Active
DSH340071U	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Outpatient Surgery (Operating Room)	215 Brightwater Drive	Lillington	NC	Active
DSH340071V	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Nuclear Medicine	215 Brightwater Drive	Lillington	NC	Active
DSH340071W	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Oncology - Oncology	225 Brightwater Drive	Lillington	NC	Active
DSH340071X	Child	DSH	HARNETT HEALTH SYSTEM, INC.	Cardiac Cath Lab - Cardiology Lab	215 Brightwater Drive	Lillington	NC	Active
DSH340071Y	Child	DSH	HARNETT HEALTH SYSTEM, INC.	HH Infusion & Injection Services - Infusion	225 Brightwater Drive	Lillington	NC	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	3/19/2025 3:14 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		3743973	3/19/2025 3:14 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		LA	3/19/2025 3:14 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1922144757	3/19/2025 3:14 PM
Medicaid Billing	NPI: State	Insert	Change Request		LA	3/19/2025 3:14 PM
Contacts	Authorizing Official	Update	Change Request	Hess, Cory President HH - CFV VP Harnett Health System 9107667100	Tart, Michael President Harnett Health System 9107667102	12/30/2024 1:40 PM
Addresses	Shipping Address	Insert	Change Request		Cape Fear Valley Lillington Pharmacy 225 Brightwater Drive Suite 110 Lillington, NC 27546	12/20/2024 8:39 AM
Details	Last Recertification Date	Update	Recertification	9/1/2023 12:58:19 PM	8/13/2024 2:39:28 PM	8/13/2024 2:39 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	7/30/2024 2:28 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		24877719	7/30/2024 2:28 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		NM	7/30/2024 2:28 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1922144757	7/30/2024 2:28 PM
Medicaid Billing	NPI: State	Insert	Change Request		NM	7/30/2024 2:28 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	2/15/2024 12:49 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		451755500	2/15/2024 12:49 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		MD	2/15/2024 12:49 PM
Medicaid Billing	Medicaid: Is Primary	Insert	Change Request		False	2/15/2024 12:49 PM
Medicaid Billing	Medicaid: Number	Insert	Change Request		009974800	2/15/2024 12:49 PM
Medicaid Billing	Medicaid: State	Insert	Change Request		FL	2/15/2024 12:49 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1922144757	2/15/2024 12:49 PM
Medicaid Billing	NPI: State	Insert	Change Request		MD	2/15/2024 12:49 PM
Medicaid Billing	NPI: Number	Insert	Change Request		1922144757	2/15/2024 12:49 PM
Medicaid Billing	NPI: State	Insert	Change Request		FL	2/15/2024 12:49 PM
Details	Last Recertification Date	Update	Recertification	9/8/2022 11:41:17 AM	9/1/2023 12:58:19 PM	9/1/2023 12:58 PM
Contacts	Primary Contact	Update	Change Request	Pope, Amy Pharmacy Director Harnett Health System 9108921000-4096	Pope, Amy Pharmacy Manager Harnett Health System 9107667074	6/15/2023 12:43 PM
Contacts	Authorizing Official	Update	Change Request	Lang, Jessica Chief Financial Officer Harnett Health System 9108921000-4016	Hess, Cory President HH - CFV VP Harnett Health System 9107667100	9/29/2022 11:23 AM
Details	Last Recertification Date	Update	Recertification	8/27/2021 8:58:26 AM	9/8/2022 11:41:17 AM	9/8/2022 11:41 AM
Details	Last Recertification Date	Update	Recertification	8/25/2020 10:03:57 AM	8/27/2021 8:58:26 AM	8/27/2021 8:58 AM
Contacts	Authorizing Official	Update	Change Request	Jones, Mike VP Support Services Harnett Health 9108921000-3003	Lang, Jessica Chief Financial Officer Harnett Health System 9108921000-4016	6/16/2021 7:49 AM
Medicaid Billing	Medicaid: Is Primary	Insert	Recertification		False	8/25/2020 10:03 AM
Medicaid Billing	Medicaid: Number	Insert	Recertification		340071	8/25/2020 10:03 AM
Medicaid Billing	Medicaid: State	Insert	Recertification		NC	8/25/2020 10:03 AM
Medicaid Billing	NPI: State	Update	Recertification		NC	8/25/2020 10:03 AM
Details	Last Recertification Date	Update	Recertification	8/27/2019 8:43:44 AM	8/25/2020 10:03:57 AM	8/25/2020 10:03 AM
Details	Last Recertification Date	Update	Recertification	8/22/2018 4:59:30 PM	8/27/2019 8:43:44 AM	8/27/2019 8:43 AM
Details	Last Recertification Date	Update	Recertification	11/9/2017 10:08:41 AM	8/22/2018 4:59:30 PM	8/22/2018 4:59 PM
Details	Last Recertification Date	Update	Recertification	8/22/2016 12:00:00 AM	11/9/2017 10:08:41 AM	11/9/2017 10:08 AM
Contacts	Authorizing Official	Update		Jones, Mike VP Support Services 9108921000-3003	Jones, Mike VP Support Services Harnett Health 9108921000-3003	10/24/2017 10:15 AM
Contacts	Primary Contact	Update		Pope, Amy Pharmacy Director 9108921000-4096	Pope, Amy Pharmacy Director Harnett Health System 9108921000-4096	9/19/2017 8:21 AM
Contacts	Primary Contact	Insert			Pope, Amy Pharmacy Director 9108921000-4096	8/22/2016 11:39 AM
Contacts	Authorizing Official	Insert			Jones, Mike VP Support Services 9108921000-3003	8/22/2016 11:39 AM
Addresses	Main Address	Insert			800 TILGHMAN DRIVE DUNN, NC 28334	8/22/2016 10:32 AM
Contacts	Signed By	Insert			Nichols, Robin CFO 9108921000-4103	8/22/2016 10:32 AM
Details	Last Recertification Date	Update		8/13/2015 12:00:00 AM	8/22/2016 12:00:00 AM	8/22/2016 10:32 AM
Details	Last Recertification Date	Update		8/7/2014 12:00:00 AM	8/13/2015 12:00:00 AM	8/13/2015 3:39 PM
Addresses	Billing Address	Insert			Harnett Health System 800 Tilghman Drive PO Box 1706 Dunn, NC 28335	12/30/2014 9:08 AM
Addresses	Shipping Address	Insert			Harnett Health System 800 Tilghman Drive Att: Pharmacy Department Dunn, NC 28334	12/30/2014 9:08 AM
Details	Last Recertification Date	Update			8/7/2014 12:00:00 AM	8/7/2014 2:19 PM
Dates	Participating Approval Date	Update		4/22/2008 12:00:00 AM	9/15/2013 12:00:00 AM	9/16/2013 4:38 PM
Dates	Signed By Date	Update			7/11/2013 12:00:00 AM	9/16/2013 4:38 PM
Details	Last Recertification Date	Update		7/1/2012 12:00:00 AM		9/15/2013 2:38 AM
Details	State	Update		Terminated	Active	9/15/2013 2:38 AM
Dates	Start Date	Update		7/1/2004 12:00:00 AM	10/1/2013 12:00:00 AM	9/15/2013 2:38 AM
Terminations	Termination Date	Update		7/1/2013 12:00:00 AM		9/15/2013 2:38 AM
Terminations	Termination Reason	Update		Other		9/15/2013 2:38 AM
Details	Comments Public	Insert			9/15/13 Enrolled 7/1/2008 and terminated 7/1/2013 at entity request. Ineligible from 7/1/2013 through 9/30/2013; reinstated effective 10/1/2013. 3/23/12 UPDATED ENTITY NAME (WAS BETSY JOHNSON REGIONAL HOSPITAL)	9/15/2013 2:38 AM
Details	State	Update		Active	Terminated	4/9/2013 12:51 PM
Terminations	Termination Date	Update			7/1/2013 12:00:00 AM	4/9/2013 12:51 PM
Terminations	Termination Reason	Update			Other	4/9/2013 12:51 PM
Details	Comments Public	Insert			4/9/13 - Per request of entity to terminate site from program participation. 3/23/12 UPDATED ENTITY NAME (WAS BETSY JOHNSON REGIONAL HOSPITAL)	4/9/2013 12:51 PM
Medicaid Billing	NPI: Number	Insert			1922144757	6/26/2012 3:58 PM
Details	Last Recertification Date	Update			7/1/2012 12:00:00 AM	5/21/2012 7:47 AM
Details	Entity Name	Update		BETSY JOHNSON REGIONAL HOSPITAL	HARNETT HEALTH SYSTEM, INC.	3/23/2012 4:06 PM
Details	Entity Subname	Update			BETSY JOHNSON REGIONAL HOSPITAL	3/23/2012 4:06 PM
Dates	Participating Approval Date	Update		4/22/2008 12:25:00 PM	4/22/2008 12:00:00 AM	3/23/2012 4:06 PM
Details	Comments Public	Insert			3/23/12 UPDATED ENTITY NAME (WAS BETSY JOHNSON REGIONAL HOSPITAL)	3/23/2012 4:06 PM
Details	Last Recertification Date	Insert				4/22/2008 12:28 PM
Details	Grant Number	Insert				4/22/2008 12:28 PM
Details	340B ID	Insert			DSH340071	4/22/2008 12:28 PM
Details	Is Authorizing Official EHB Data	Insert				4/22/2008 12:28 PM
Dates	Last Date That 340B Drugs Purchased	Insert				4/22/2008 12:28 PM
Details	Medicare Provider Number	Insert			340071	4/22/2008 12:28 PM
Details	Entity Name	Insert			BETSY JOHNSON REGIONAL HOSPITAL	4/22/2008 12:28 PM
Details	Program Code	Insert			DSH	4/22/2008 12:28 PM
Details	Entity Subname	Insert				4/22/2008 12:28 PM
Dates	Participating Approval Date	Insert			4/22/2008 12:25:00 PM	4/22/2008 12:28 PM
Details	State	Insert			Active	4/22/2008 12:28 PM
Dates	Registration Date	Insert			4/22/2008 12:00:00 AM	4/22/2008 12:28 PM
Dates	Signed By Date	Insert				4/22/2008 12:28 PM
Dates	Start Date	Insert			7/1/2004 12:00:00 AM	4/22/2008 12:28 PM
Terminations	Termination Comments	Insert				4/22/2008 12:28 PM
Terminations	Termination Date	Insert				4/22/2008 12:28 PM
Terminations	Termination Effective Date	Insert				4/22/2008 12:28 PM
Terminations	Termination Reason	Insert				4/22/2008 12:28 PM