Covered Entity Details

DSH340070V ALAMANCE REGIONAL MEDICAL CENTER (Terminated) - information as of 5/16/2025 11:31:57 PM

Main Details

Name

ALAMANCE REGIONAL MEDICAL CENTER

Subdivision Name

Cone Health Imaging at MedCenter Mebane/ CT Scan

Type

Disproportionate Share Hospital

Rural

340B ID

DSH340070V

Medicare Provider Number

340070

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

4/10/2015

Participating Start Date

7/1/2015

Participating Approval Date

5/21/2015

Last Recertification Date

8/31/2021

Termination Date
Termination Reason

4/1/2022
Business decision by the Covered Entity

Contacts

Authorizing Official

Cone Health
Andrew Barrow, Chief Financial Officer
(336) 832-7825

Primary Contact

Cone Health
Alex Kidd, Pharmacy Business Manager
(336) 890-3625

Addresses

Street Address

3940 Arrowhead Blvd
Suite 120
Mebane, NC 27302

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

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	340070	1326010273

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH340070A	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	MEDCENTER MEBANE SURGERY CENTER	3940 ARROWHEAD BLVD.	MEBANE	NC	Terminated
DSH340070B	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Graham Outpatient Imaging	1205 SOUTH MAIN STREET	GRAHAM	NC	Terminated
DSH340070C	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	CONE HEALTH CANCER CENTER AT ALAMANCE REGIONAL	1236 HUFFMAN MILL RD, Suite 120	BURLINGTON	NC	Terminated
DSH340070D	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	WOUND HEALING CENTER AT ALAMANCE REGIONAL	1248 HUFFMAN MILL ROAD	BURLINGTON	NC	Terminated
DSH340070E	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	CONE HEALTH CANCER CENTER AT MEDCENTER MEBANE	3940 ARROWHEAD BLVD.	MEBANE	NC	Terminated
DSH340070F	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	SLEEP DISORDER CENTER AT ALAMANCE REGIONAL	1248 HUFFMAN MILL ROAD	BURLINGTON	NC	Terminated
DSH340070G	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Physical and Sports Rehabilitation Clinic	2282 SOUTH CHURCH STREET	BURLINGTON	NC	Terminated
DSH340070H	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	CONE HEALTH MEBANE PHYSICAL THERAPY	102-A MEDICAL PARK DRIVE	MEBANE	NC	Terminated
DSH340070J	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Alamance Regional Outpatient Imaging Center / Diagnostic Radiology	2903 Professional Park Drive, Suite B	Burlington	NC	Terminated
DSH340070K	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Alamance Regional Outpatient Imaging Center / Radioisotope	2903 Professional Park Drive, Suite B	Burlington	NC	Terminated
DSH340070L	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Alamance Regional Outpatient Imaging Center / CT Scan	2903 Professional Park Drive, Suite B	Burlington	NC	Terminated
DSH340070M	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Cone Health Pediatric Rehabilitation Center at Burlington/Physical Therapy	519 Boone Station, Suite 108	Burlington	NC	Terminated
DSH340070N	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Cone Health Pediatric Rehabilitation Center at Burlington/Occupational Therapy	519 Boone Station, Suite 108	Burlington	NC	Terminated
DSH340070P	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Cone Health Pediatric Rehabilitation Center at Burlington/Speech Pathology	519 Boone Station, Suite 108	Burlington	NC	Terminated
DSH340070Q	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Alamance Regional Pain Clinic	1236 Huffman Mill Road, Suite 2000	Burlington	NC	Terminated
DSH340070R	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Nutrition and Diabetes Education Services at Alamance Regional	1238 Grand Oaks Blvd	BURLINGTON	NC	Terminated
DSH340070S	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Physical and Sports Rehabilitation Clinic / Occupational Therapy	2282 South Church Street	Burlington	NC	Terminated
DSH340070T	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Cone Health Imaging at MedCenter Mebane/Diagnostic Radiology	3940 Arrowhead Blvd	Mebane	NC	Terminated
DSH340070V	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Cone Health Imaging at MedCenter Mebane/ CT Scan	3940 Arrowhead Blvd	Mebane	NC	Terminated
DSH340070W	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	HEART FAILURE CLINIC AT ALAMANCE REGIONAL MEDICAL CENTER - HEART FAILURE	1236 Huffman Mill Road, Suite 2100	Burlington	NC	Terminated
DSH340070X	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	Alamance Regional Medical Center Infectious Disease - Infectious Disease	1236 Huffman Mill Road	Burlington	NC	Terminated
DSH340070Y	Child	DSH	ALAMANCE REGIONAL MEDICAL CENTER	CONE HEALTH CANCER CENTER AT ALAMANCE REGIONAL - Radiation Therapy	1236 Huffman Mill Road	Burlington	NC	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Profile Change Request	Kidd, Alex Pharmacy Business Manager Cone Health 3368322124	Kidd, Alex Pharmacy Business Manager Cone Health 3368903625	4/16/2024 2:16 PM
Details	State	Update		To Be Terminated	Terminated	4/1/2022 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		1/31/2022 12:00:00 AM	2/3/2022 7:22 AM
Details	State	Update	Termination Request	Active	To Be Terminated	2/3/2022 7:22 AM
Terminations	Termination Date	Update	Termination Request		4/1/2022 12:00:00 AM	2/3/2022 7:22 AM
Terminations	Termination Effective Date	Update	Termination Request		2/1/2022 12:00:00 AM	2/3/2022 7:22 AM
Terminations	Termination Reason	Update	Termination Request		Business decision by the Covered Entity	2/3/2022 7:22 AM
Medicaid Billing	Medicaid: Number	Delete	Recertification	403163 (SC)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1326010273 (VA)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	000499012X (GA)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	02204451 (NY)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	418679600 (MD)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	097584200 (FL)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	032067300 (DC)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	4172701 (NJ)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	2999573 (OH)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1326010273 (CA)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1326010273 (MI)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1326010273 (WV)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	072533502 (TX)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	01520634 (KY)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	003050515 (CT)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	340070 (TN)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	752548221 (AL)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1326010273 (WA)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1326010273 (IA)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1326010273 (MN)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1326010273 (ID)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	1326010273 (SD)		8/31/2021 12:17 PM
Medicaid Billing	Medicaid: Number	Delete	Recertification	200913450A (IN)		8/31/2021 12:17 PM
Details	Last Recertification Date	Update	Recertification	9/4/2020 8:49:59 AM	8/31/2021 12:17:06 PM	8/31/2021 12:17 PM
Contacts	Authorizing Official	Update	AO Change Request	Jones, Jeffrey Executive VP and CFO Cone Health 3368328005	Barrow, Andrew Chief Financial Officer Cone Health 3368327825	3/8/2021 2:40 PM
Medicaid Billing	NPI: State	Update	Recertification		NC	9/4/2020 8:49 AM
Details	Last Recertification Date	Update	Recertification	9/9/2019 7:18:04 AM	9/4/2020 8:49:59 AM	9/4/2020 8:49 AM
Details	Entity Subname	Update	Recertification	Cone Health MedCenter Mebane/ CT Scan	Cone Health Imaging at MedCenter Mebane/ CT Scan	9/4/2020 8:49 AM
Details	Last Recertification Date	Update	Recertification	9/3/2018 9:30:11 AM	9/9/2019 7:18:04 AM	9/9/2019 7:18 AM
Addresses	Main Address	Update	Change Request	3940 Arrowhead Blvd, Building A Suite 120 Mebane, NC 27302	3940 Arrowhead Blvd Suite 120 Mebane, NC 27302	12/7/2018 2:17 PM
Medicaid Billing	Medicaid: State	Update	Change Request	MA	MD	12/7/2018 2:17 PM
Details	Last Recertification Date	Update	Recertification	11/14/2017 1:27:55 PM	9/3/2018 9:30:11 AM	9/3/2018 9:30 AM
Details	Entity Subname	Update	Recertification	Alamance Regional Mebane Outpatient Center / CT Scan	Cone Health MedCenter Mebane/ CT Scan	9/3/2018 9:30 AM
Medicaid Billing	Medicaid: Number	Update	Change Request	0340091	340070	5/16/2018 7:48 AM
Medicaid Billing	Medicaid: State	Update	Change Request	TX	TN	5/16/2018 7:48 AM
Details	Last Recertification Date	Update	Recertification	8/22/2016 12:00:00 AM	11/14/2017 1:27:55 PM	11/14/2017 1:27 PM
Contacts	Authorizing Official	Update		Jones, Jeffrey Executive VP and CFO 3368328005	Jones, Jeffrey Executive VP and CFO Cone Health 3368328005	10/2/2017 3:13 PM
Contacts	Signed By	Update		Jones, Jeffrey Executive VP and CFO 3368328005	Jones, Jeffrey Executive VP and CFO Cone Health 3368328005	10/2/2017 3:13 PM
Contacts	Primary Contact	Update		Kidd, Alex Pharmacy Business Manager 3368322124	Kidd, Alex Pharmacy Business Manager Cone Health 3368322124	9/20/2017 1:22 PM
Contacts	Authorizing Official	Insert			Jones, Jeffrey Executive VP and CFO 3368328005	8/3/2017 8:07 AM
Contacts	Signed By	Insert			Jones, Jeffrey Executive VP and CFO 3368328005	8/3/2017 8:07 AM
Contacts	Primary Contact	Insert			Kidd, Alex Pharmacy Business Manager 3368322124	8/2/2017 10:13 AM
Details	Last Recertification Date	Update		8/12/2015 12:00:00 AM	8/22/2016 12:00:00 AM	8/22/2016 1:55 PM
Addresses	Main Address	Insert			3940 Arrowhead Blvd, Building A Suite 120 Mebane, NC 27302	8/22/2016 1:55 PM
Medicaid Billing	Medicaid: Number	Update		1477591055	1326010273	12/3/2015 12:20 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			02204451	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			NY	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			418679600	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			MA	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			097584200	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			FL	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			032067300	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			DC	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			4172701	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			NJ	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			2999573	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			OH	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			1326010273	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			CA	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			1326010273	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			MI	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			1326010273	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			WV	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			072533502	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			TX	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			01520634	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			KY	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			003050515	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			CT	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			0340091	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			TX	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			752548221	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			AL	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			1326010273	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			WA	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			1326010273	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			IA	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			1326010273	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			MN	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			1326010273	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			ID	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			1326010273	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			SD	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: Number	Insert			200913450A	11/24/2015 2:34 PM
Medicaid Billing	Medicaid: State	Insert			IN	11/24/2015 2:34 PM
Details	Last Recertification Date	Update			8/12/2015 12:00:00 AM	8/12/2015 9:23 AM
Dates	Participating Approval Date	Update			5/21/2015 12:00:00 AM	5/21/2015 11:40 AM
Details	State	Update		Pending	Active	5/21/2015 11:40 AM
Dates	Start Date	Update			7/1/2015 12:00:00 AM	5/21/2015 11:40 AM
Details	340B ID	Update		OUTPATIENT_ONLINE_REG_51027	DSH340070V	5/13/2015 8:55 AM
Details	340B ID	Update			OUTPATIENT_ONLINE_REG_51027	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: Number	Insert			340070	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: State	Insert			NC	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: Number	Insert			403163	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: State	Insert			SC	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: Number	Insert			1477591055	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: State	Insert			VA	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: Is Primary	Insert			False	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: Number	Insert			000499012X	4/10/2015 10:06 AM
Medicaid Billing	Medicaid: State	Insert			GA	4/10/2015 10:06 AM
Medicaid Billing	NPI: Number	Insert			1326010273	4/10/2015 10:06 AM
Details	Last Recertification Date	Insert				4/10/2015 10:06 AM
Details	Grant Number	Insert				4/10/2015 10:06 AM
Details	340B ID	Insert				4/10/2015 10:06 AM
Details	Is Authorizing Official EHB Data	Insert				4/10/2015 10:06 AM
Dates	Last Date That 340B Drugs Purchased	Insert				4/10/2015 10:06 AM
Details	Medicare Provider Number	Insert			340070	4/10/2015 10:06 AM
Details	Entity Name	Insert			ALAMANCE REGIONAL MEDICAL CENTER	4/10/2015 10:06 AM
Details	Program Code	Insert			DSH	4/10/2015 10:06 AM
Details	Entity Subname	Insert			Alamance Regional Mebane Outpatient Center / CT Scan	4/10/2015 10:06 AM
Dates	Participating Approval Date	Insert				4/10/2015 10:06 AM
Details	State	Insert			Pending	4/10/2015 10:06 AM
Dates	Registration Date	Insert			4/10/2015 12:00:00 AM	4/10/2015 10:06 AM
Dates	Signed By Date	Insert			4/10/2015 12:00:00 AM	4/10/2015 10:06 AM
Dates	Start Date	Insert				4/10/2015 10:06 AM
Terminations	Termination Comments	Insert				4/10/2015 10:06 AM
Terminations	Termination Date	Insert				4/10/2015 10:06 AM
Terminations	Termination Effective Date	Insert				4/10/2015 10:06 AM
Terminations	Termination Reason	Insert				4/10/2015 10:06 AM