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DSH340145 Atrium Health Lincoln (Terminated)
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Main Details
Name
Atrium Health Lincoln
Subdivision Name
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340145
Medicare Provider Number
340145
Additional Details
Current Program Status
Terminated
Registration Date
4/23/2008
Participating Start Date
7/1/2004
Participating Approval Date
4/23/2008
Last Recertification Date
9/14/2020
Termination Date
Termination Reason
10/1/2021
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
433 MCALISTER ROAD
LINCOLNTON, NC 28092
Billing Address
Atrium Health Accounts Payable
PO Box 5379
Portland, OR 97228-5379
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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4/23/08 MOVED ADDR LINE 2 TO BILL TO ADDR; 4/24/08 ENT NAME CHANGE (WAS LINCOLN HEALTH SYSTEM DBA LINCOLN MEDICAL CENTER)09/23/10 UPDATED ADDR(WAS 200 GAMBLE DRIVE)
09/23/2010
May 2025
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