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DSH340032T GASTON MEMORIAL HOSPITAL (Active)
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Main Details
Name
GASTON MEMORIAL HOSPITAL
Subdivision Name
CAROMONT DIABETES CENTER - Diabetes
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340032T
Medicare Provider Number
340032
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/6/2025
Participating Start Date
4/1/2025
Participating Approval Date
2/3/2025
Last Recertification Date
Contacts
Authorizing Official
Caromont Regional Medical Center
David O’Connor, CFO
(704) 834-2127
Primary Contact
CaroMont Regional Medical Center
Mark Chaparro, Pharmacy Director
(704) 834-2239
Addresses
Street Address
640 SUMMIT CROSSING PL
STE 205
GASTONIA, NC 28054-2183
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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