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DSH100230 MEMORIAL HOSPITAL PEMBROKE (Active)
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Main Details
Name
MEMORIAL HOSPITAL PEMBROKE
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100230
Medicare Provider Number
100230
Additional Details
Current Program Status
Active
Registration Date
9/4/2007
Participating Start Date
1/1/2003
Participating Approval Date
9/4/2007
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Memorial Hospital Pembroke
Felicia Cephus Turnley, Chief Executive Officer
(954) 883-8482
Primary Contact
Memorial Healthcare System
Alexsandra Soto, Director, 340B Program
(954) 276-1771
Addresses
Street Address
7800 SHERIDAN STREET
PEMBROKE PINES, FL 33024
Billing Address
Memorial Healthcare System
P.O. BOX 269001
Attn: Accounts Payable
Pembroke Pines, FL 33026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/7/2010- AMDP- NETWORK- SOUTH BROWARD HOSPITAL DISTRICT;
09/04/2007
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