Covered Entity Details

RRC340115-29 FIRSTHEALTH MOORE REGIONAL HOSPITAL (Active) - information as of 5/23/2025 12:13:36 AM

Main Details

Name

FIRSTHEALTH MOORE REGIONAL HOSPITAL

Subdivision Name

FirstHealth Outpatient Infectious Disease Clinic

Type

Rural Referral Center

Rural

Yes

340B ID

RRC340115-29

Medicare Provider Number

340115

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

4/6/2020

Participating Start Date

4/15/2020

Participating Approval Date

4/9/2020

Last Recertification Date

8/14/2024

Contacts

Authorizing Official

FirstHealth Moore Regional Hospital
Chris Fraley, Vice President, Finance
(910) 715-1894

Primary Contact

FirstHealth Moore Regional Hospital
Drew Kessell, Director, Clinical Pharmacy Services
(910) 715-1105

Addresses

Street Address

220 PAGE ROAD NORTH
Suite 300
Pinehurst, NC 28374

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		1740208081

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
Contract Detail	REALO SPECIALTY CARE PHARMACY, INC	860 AVIATION PKWY STE 1400		MORRISVILLE	NC	27560	01/05/2021	04/01/2021			04/01/2021

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
RRC340115-01	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Pinehurst Cancer Center-Medical Oncology	135 PAGE ROAD NORTH	PINEHURST	NC	Active
RRC340115-02	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Outpatient Wound Care Clinic	220 PAGE RD N	PINEHURST	NC	Active
RRC340115-05	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Outpatient Pain Management Clinic	220 PAGE RD N	PINEHURST	NC	Active
RRC340115-06	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Outpatient Behavioral Services	35 MEMORIAL DRIVE	PINEHURST	NC	Active
RRC340115-07	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	OUTPATIENT IMAGING	30 MEMORIAL DRIVE	PINEHURST	NC	Terminated
RRC340115-09	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FIRSTHEALTH RICHMOND MEMORIAL HOSPITAL	925 LONG DRIVE	ROCKINGHAM	NC	Terminated
RRC340115-10	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Sanford Hematology and Oncology-Medical Oncology	1212 CENTRAL DRIVE	SANFORD	NC	Active
RRC340115-13	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus Radiology Diagnostic	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-15	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	RMH Pediatrics	925 S. LONG DRIVE	ROCKINGHAM	NC	Terminated
RRC340115-16	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus Medical Surgical Unit	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-17	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus PACU/ Recovery Room	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-18	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus Operating Room	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-19	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus Outpatient Services	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-20	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus Emergency Room	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-21	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	RMH Second Floor Medical	925 S. LONG DRIVE	ROCKINGHAM	NC	Terminated
RRC340115-22	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Hoke Campus Medical Surgical Unit	6408 FAYETTEVILLE RD	RAEFORD	NC	Active
RRC340115-23	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Hoke Campus Outpatient Wound Care Clinic	6322 FAYETTEVILLE RD	RAEFORD	NC	Active
RRC340115-24	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Hoke Campus Emergency Room	6408 FAYETTEVILLE RD	RAEFORD	NC	Active
RRC340115-25	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus Outpatient Wound Care Clinic	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-26	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Hoke Campus Nuclear Medicine	6408 FAYETTEVILLE RD	RAEFORD	NC	Active
RRC340115-27	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus Nuclear Medicine	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-28	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Hoke Campus Operating Room	6408 FAYETTEVILLE RD	RAEFORD	NC	Active
RRC340115-29	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Outpatient Infectious Disease Clinic	220 PAGE ROAD NORTH	Pinehurst	NC	Active
RRC340115-30	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Hoke Campus Radiology Diagnostic	6408 FAYETTEVILLE RD	RAEFORD	NC	Active
RRC340115-31	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Outpatient Neurology Clinic	220 PAGE ROAD NORTH	PINEHURST	NC	Active
RRC340115-32	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Outpatient Diabetes Center	220 PAGE RD N	PINEHURST	NC	Active
RRC340115-33	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus Intensive Care Unit	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-34	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Pinehurst Cancer Center-Radiation Oncology	135 PAGE ROAD NORTH	PINEHURST	NC	Active
RRC340115-35	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Hoke Campus PACU/Recovery Room	6408 FAYETTEVILLE RD	RAEFORD	NC	Active
RRC340115-36	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus GI Lab	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-37	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Hoke Campus Cardio Lab - Cardio Lab	6408 Fayetteville Road	Raeford	NC	Active
RRC340115-38	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth FPG Outpatient Weight Management Clinic	220 PAGE RD N	PINEHURST	NC	Active
RRC340115-39	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus Extended Care Unit	925 S. LONG DRIVE	ROCKINGHAM	NC	Active
RRC340115-40	Child	RRC	FIRSTHEALTH MOORE REGIONAL HOSPITAL	FirstHealth Richmond Campus -- Cardio Lab - Cardio Lab	925 S. Long Drive	Rockingham	NC	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Addresses	Main Address	Update	Change Request	220 Page Road Suite 300 Pinehurst, NC 28374	220 PAGE ROAD NORTH Suite 300 Pinehurst, NC 28374	5/20/2025 9:19 AM
Addresses	Main Address	Update	Change Request	35 Memorial Drive Pinehurst, NC 28374	220 Page Road Suite 300 Pinehurst, NC 28374	5/7/2025 8:50 AM
Addresses	Main Address	Update	Change Request	35 memorial dr pinehurst, NC 28374	35 Memorial Drive Pinehurst, NC 28374	11/14/2024 6:58 AM
Details	Entity Subname	Update	Change Request	infectious disease - infectious disease clinic	FirstHealth Outpatient Infectious Disease Clinic	11/14/2024 6:58 AM
Contacts	Authorizing Official	Update	Change Request	CASEY, JEFF VICE PRESIDENT OF FINANCE firsthealth of the carolinas 9107151561	Fraley, Chris Vice President, Finance FirstHealth Moore Regional Hospital 9107151894	9/17/2024 8:08 AM
Details	Last Recertification Date	Update	Recertification	8/29/2023 1:46:40 PM	8/14/2024 9:05:40 AM	8/14/2024 9:05 AM
Contacts	Primary Contact	Update	Profile Change Request	Kessell, Drew Clinic Director of Pharmacy FirstHealth Moore Regional Hospital 9107151105	Kessell, Drew Director, Clinical Pharmacy Services FirstHealth Moore Regional Hospital 9107151105	4/4/2024 12:59 PM
Details	Last Recertification Date	Update	Recertification	8/24/2022 6:44:47 AM	8/29/2023 1:46:40 PM	8/29/2023 1:46 PM
Details	Last Recertification Date	Update	Recertification	8/19/2021 3:31:14 PM	8/24/2022 6:44:47 AM	8/24/2022 6:44 AM
Details	Last Recertification Date	Update	Recertification	8/26/2020 5:16:26 PM	8/19/2021 3:31:14 PM	8/19/2021 3:31 PM
Medicaid Billing	NPI: State	Update	Recertification		NC	8/26/2020 5:16 PM
Details	Last Recertification Date	Update	Recertification		8/26/2020 5:16:26 PM	8/26/2020 5:16 PM
Details	State	Update	OPA Edit	Approved	Active	4/15/2020 3:06 PM
Dates	Start Date	Update	OPA Edit	7/1/2020 12:00:00 AM	4/15/2020 12:00:00 AM	4/15/2020 3:06 PM
Contacts	Signed By	Insert	New Registration		CASEY, JEFF VICE PRESIDENT OF FINANCE firsthealth of the carolinas 9107151561	4/9/2020 12:44 PM
Details	340B ID	Update	New Registration		RRC340115-29	4/9/2020 12:44 PM
Details	Entity Subname	Update	New Registration	infectious disease	infectious disease - infectious disease clinic	4/9/2020 12:44 PM
Dates	Participating Approval Date	Update	New Registration		4/9/2020 12:44:41 PM	4/9/2020 12:44 PM
Details	State	Update	New Registration	Pending	Approved	4/9/2020 12:44 PM
Dates	Signed By Date	Update	New Registration		4/6/2020 1:54:20 PM	4/9/2020 12:44 PM
Dates	Start Date	Update	New Registration		7/1/2020 12:00:00 AM	4/9/2020 12:44 PM
Addresses	Main Address	Insert	New Registration		35 memorial dr pinehurst, NC 28374	4/6/2020 1:54 PM
Medicaid Billing	NPI: Number	Insert	New Registration		1740208081	4/6/2020 1:54 PM
Contacts	Authorizing Official	Insert	New Registration		CASEY, JEFF VICE PRESIDENT OF FINANCE firsthealth of the carolinas 9107151561	4/6/2020 1:54 PM
Contacts	Primary Contact	Insert	New Registration		Kessell, Drew Clinic Director of Pharmacy FirstHealth Moore Regional Hospital 9107151105	4/6/2020 1:54 PM
Details	Last Recertification Date	Insert	New Registration			4/6/2020 1:54 PM
Details	Grant Number	Insert	New Registration			4/6/2020 1:54 PM
Details	340B ID	Insert	New Registration			4/6/2020 1:54 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			4/6/2020 1:54 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			4/6/2020 1:54 PM
Details	Medicare Provider Number	Insert	New Registration		340115	4/6/2020 1:54 PM
Details	Entity Name	Insert	New Registration		FIRSTHEALTH MOORE REGIONAL HOSPITAL	4/6/2020 1:54 PM
Details	Program Code	Insert	New Registration		RRC	4/6/2020 1:54 PM
Details	Entity Subname	Insert	New Registration		infectious disease	4/6/2020 1:54 PM
Dates	Participating Approval Date	Insert	New Registration			4/6/2020 1:54 PM
Details	State	Insert	New Registration		Pending	4/6/2020 1:54 PM
Dates	Registration Date	Insert	New Registration		4/6/2020 1:54:14 PM	4/6/2020 1:54 PM
Dates	Signed By Date	Insert	New Registration			4/6/2020 1:54 PM
Dates	Start Date	Insert	New Registration			4/6/2020 1:54 PM
Terminations	Termination Comments	Insert	New Registration			4/6/2020 1:54 PM
Terminations	Termination Date	Insert	New Registration			4/6/2020 1:54 PM
Terminations	Termination Effective Date	Insert	New Registration			4/6/2020 1:54 PM
Terminations	Termination Reason	Insert	New Registration			4/6/2020 1:54 PM