340B Drug Pricing Program Database


CAH341315-06 Bladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County Hospital (Active) - information as of 5/27/2025 4:02:24 PM

Main Details
Bladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County Hospital
CFV BLADEN MEDICAL ASSOCIATES - BMA White Lake
Critical Access Hospital
Yes
CAH341315-06
341315
343469


Additional Details
Active
10/13/2020
1/1/2021
10/14/2020
8/16/2024

Contacts

Bladen County Hospital
Spencer Lowell Cummings, President
(910) 862-5149

Bladen Healthcare, LLC dba CFVHS-Bladen County Hospital
Karen Gentry, Pharmacy Director
(910) 862-5157

Addresses

273 WHITE LAKE DR
ELIZABETHTOWN, NC 28337-6885

CFV-Bladen County Hospital
PO Box 398
Elizabethtown, NC 28337


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Parent/Child
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
NC15285596711528559671
Shipping Addresses

Same as Street Address
Parent/Child
340B IDHierarchyEntity TypeNameSub NameAddressCityState340B Status
CAH341315-01ChildCAHBladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County HospitalCAPE FEAR VALLEY BLADEN MEDICAL16 3RD STDUBLINNCActive
CAH341315-02ChildCAHBladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County HospitalCAPE FEAR VALLEY-BLADEN MEDICAL ASS1106 W SEABOARD STREETBLADENBORONCActive
CAH341315-03ChildCAHBladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County HospitalCAPE FEAR VALLEY - BLADEN MEDICAL A300 A EAST MCKAY STREETELIZABETHTOWNNCActive
CAH341315-04ChildCAHBladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County HospitalCAPE FEAR VALLEY-BLADEN MEDICAL EXP107 EAST DUNHAM STELIZABETHTOWNNCActive
CAH341315-05ChildCAHBladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County HospitalCFV BLADEN MEDICAL ASSOCIATES - Family medicine practice9858 WR Lathan DriveCLARKTONNCActive
CAH341315-06ChildCAHBladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County HospitalCFV BLADEN MEDICAL ASSOCIATES - BMA White Lake273 WHITE LAKE DRELIZABETHTOWNNCActive
CAH341315-07ChildCAHBladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County HospitalCFV PRIMARY CARE-VINELAND FAMILY ME - Family Medicine630 S MADISON STWHITEVILLENCActive
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification8/15/2023 9:25:16 AM8/16/2024 2:52:13 PM8/16/2024 2:52 PM
ContactsAuthorizing OfficialUpdateAO Change RequestFife, Stephen President & CFO Bladen Healthcare, LLC 9108625149Cummings, Spencer Lowell President Bladen County Hospital 910862514910/12/2023 11:35 AM
DetailsLast Recertification DateUpdateRecertification8/31/2022 3:15:05 PM8/15/2023 9:25:16 AM8/15/2023 9:25 AM
DetailsLast Recertification DateUpdateRecertification8/26/2021 1:32:16 PM8/31/2022 3:15:05 PM8/31/2022 3:15 PM
DetailsLast Recertification DateUpdateRecertification 8/26/2021 1:32:16 PM8/26/2021 1:32 PM
DetailsStateUpdate ApprovedActive1/1/2021 12:01 AM
ContactsSigned ByInsertNew Registration Fife, Stephen President & CFO Bladen Healthcare, LLC 910862514910/14/2020 9:57 AM
Details340B IDUpdateNew Registration CAH341315-0610/14/2020 9:57 AM
DetailsEntity NameUpdateNew RegistrationBLADEN COUNTY HOSPITALBladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County Hospital10/14/2020 9:57 AM
DetailsEntity SubnameUpdateNew RegistrationCFV BLADEN MEDICAL ASSOCIATESCFV BLADEN MEDICAL ASSOCIATES - BMA White Lake10/14/2020 9:57 AM
DatesParticipating Approval DateUpdateNew Registration 10/14/2020 9:57:52 AM10/14/2020 9:57 AM
DetailsStateUpdateNew RegistrationPendingApproved10/14/2020 9:57 AM
DatesSigned By DateUpdateNew Registration 10/13/2020 5:06:41 PM10/14/2020 9:57 AM
DatesStart DateUpdateNew Registration 1/1/2021 12:00:00 AM10/14/2020 9:57 AM
ContactsAuthorizing OfficialUpdateProfile Change RequestFife, Stephen Director of Finance Bladen Healthcare, LLC 9108625149Fife, Stephen President & CFO Bladen Healthcare, LLC 910862514910/14/2020 7:59 AM
AddressesMain AddressInsertNew Registration  273 WHITE LAKE DR ELIZABETHTOWN, NC 28337-688510/13/2020 12:57 PM
AddressesBilling AddressInsertNew Registration CFV-Bladen County Hospital PO Box 398 Elizabethtown, NC 2833710/13/2020 12:57 PM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False10/13/2020 12:57 PM
Medicaid BillingMedicaid: NumberInsertNew Registration 152855967110/13/2020 12:57 PM
Medicaid BillingMedicaid: StateInsertNew Registration NC10/13/2020 12:57 PM
Medicaid BillingNPI: NumberInsertNew Registration 152855967110/13/2020 12:57 PM
Medicaid BillingNPI: StateInsertNew Registration NC10/13/2020 12:57 PM
ContactsPrimary ContactInsertNew Registration Gentry, Karen Pharmacy Director Bladen Healthcare, LLC dba CFVHS-Bladen County Hospital 910862515710/13/2020 12:57 PM
ContactsAuthorizing OfficialInsertNew Registration Fife, Stephen Director of Finance Bladen Healthcare, LLC 910862514910/13/2020 12:57 PM
DetailsAssistance Received From DateInsertNew Registration  10/13/2020 12:57 PM
DetailsAssistance Received To DateInsertNew Registration  10/13/2020 12:57 PM
DetailsLast Recertification DateInsertNew Registration  10/13/2020 12:57 PM
DetailsGrant NumberInsertNew Registration  10/13/2020 12:57 PM
Details340B IDInsertNew Registration  10/13/2020 12:57 PM
DetailsIs Authorizing Official EHB DataInsertNew Registration  10/13/2020 12:57 PM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  10/13/2020 12:57 PM
DetailsMedicare Provider NumberInsertNew Registration 34131510/13/2020 12:57 PM
DetailsEntity NameInsertNew Registration BLADEN COUNTY HOSPITAL10/13/2020 12:57 PM
DetailsNOFO NumberInsertNew Registration  10/13/2020 12:57 PM
DetailsProgram CodeInsertNew Registration CAH10/13/2020 12:57 PM
DetailsEntity SubnameInsertNew Registration CFV BLADEN MEDICAL ASSOCIATES10/13/2020 12:57 PM
DatesParticipating Approval DateInsertNew Registration  10/13/2020 12:57 PM
DetailsStateInsertNew Registration Pending10/13/2020 12:57 PM
DatesRegistration DateInsertNew Registration 10/13/2020 12:57:49 PM10/13/2020 12:57 PM
DatesSigned By DateInsertNew Registration  10/13/2020 12:57 PM
DatesStart DateInsertNew Registration  10/13/2020 12:57 PM
TerminationsTermination CommentsInsertNew Registration  10/13/2020 12:57 PM
TerminationsTermination DateInsertNew Registration  10/13/2020 12:57 PM
TerminationsTermination Effective DateInsertNew Registration  10/13/2020 12:57 PM
TerminationsTermination ReasonInsertNew Registration  10/13/2020 12:57 PM