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DSH340014C Forsyth Memorial Hospital, Inc d/b/a Novant Health Forsyth Medical Center (Terminated)
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Main Details
Name
Forsyth Memorial Hospital, Inc d/b/a Novant Health Forsyth Medical Center
Subdivision Name
Novant Health Winston-Salem Health Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340014C
Medicare Provider Number
340014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
6/12/2009
Participating Start Date
7/1/2009
Participating Approval Date
6/15/2009
Last Recertification Date
9/6/2019
Termination Date
Termination Reason
7/7/2020
DSH percentage below statutory minimum
Contacts
Authorizing Official
Novant Health
Geoffrey Gardner, SVP Finance
(336) 718-2078
Primary Contact
Novant Health
Elizabeth Anne Corazzo, Manager Pharmacy 340B
(336) 277-0301
Addresses
Street Address
250 CHARLOIS BLVD.
WINSTON SALEM, NC 27103
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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8/17/09 CHANGE MEDICAID BILLING TO 'NO' AND REMOVED NUMBER (WAS 0855196)
09/25/2009
April 2025
April 2025
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