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DSH340130 ATRIUM HEALTH UNION (Terminated)
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Main Details
Name
ATRIUM HEALTH UNION
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340130
Medicare Provider Number
340130
Additional Details
Current Program Status
Terminated
Registration Date
4/12/2024
Participating Start Date
7/1/2024
Participating Approval Date
4/29/2024
Last Recertification Date
Termination Date
Termination Reason
7/1/2024
DSH percentage below statutory minimum
Contacts
Authorizing Official
Atrium Health
Don McCoy Mabe, VP, Pharmacy
(704) 512-7623
Primary Contact
Atrium Health
Fern Paul-Aviles, AVP, Pharmacy
(704) 649-9691
Addresses
Street Address
600 HOSPITAL DRIVE
MONROE, NC 28111
Billing Address
Atrium Health Accounts Payable
PO Box 516
Elmsford, NY 10523
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 10/1/2023, Termination Date 10/1/2023, Reinstatement 7/1/2024
04/23/2024
Participated starting 7/1/2004; Terminated 10/1/2022; Reinstated 10/1/2023.
09/05/2023
1/30/12 REMOVED MEDICAID # (WAS NC-905141); 1/25/2011- ADDED BILL TO; 4/23/08 ENT NAME CHANGE (WAS UNION REGIONAL MEDICAL CENTER)
01/30/2012
1/25/2011- ADDED BILL TO; 4/23/08 ENT NAME CHANGE (WAS UNION REGIONAL MEDICAL CENTER)
01/26/2011
April 2025
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