340B Drug Pricing Program Database
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RRC340014-90 FORSYTH MEMORIAL HOSPITAL INC (Active)
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Main Details
Name
FORSYTH MEMORIAL HOSPITAL INC
Subdivision Name
NH KMC Cardiac Cath Lab - Heart Cath
Type
Rural Referral Center
Rural
Yes
340B ID
RRC340014-90
Medicare Provider Number
340014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/11/2024
Participating Start Date
10/1/2024
Participating Approval Date
8/23/2024
Last Recertification Date
Contacts
Authorizing Official
Novant Health, Inc.
Rebecca A Bean, SVP Chief Pharmacy Executive
(336) 277-5862
Primary Contact
Novant Health, Inc
Elizabeth Anne Corazzo, Pharmacy Manager 340B
(336) 277-0301
Addresses
Street Address
1750 KERNERSVILLE MEDICAL PARKWAY
Kernersville, NC 27284
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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