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CH04580H GOSHEN MEDICAL CENTER, INC. (Terminated)
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Main Details
Name
GOSHEN MEDICAL CENTER, INC.
Subdivision Name
Goshen Medical Center - Women's Health
Type
HRSA-Funded Health Center
Site ID
BPS-H80-009342
340B ID
CH04580H
Grant Number
H80CS00181
Additional Details
Current Program Status
Terminated
Registration Date
3/1/2011
Participating Start Date
4/1/2011
Participating Approval Date
3/2/2011
Last Recertification Date
2/12/2018
Termination Date
Termination Reason
10/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Goshen Medical Center, Inc.
GREG BOUNDS, CEO
(910) 267-1942 Ext: 1117
Primary Contact
Goshen Medical Center, Inc.
Diane Graham, Chief Accounting Officer
(910) 267-2057 Ext: 1358
Addresses
Street Address
212 Duplin St
Kenansville, NC 28349
Billing Address
GOSHEN MEDICAL CENTER, INC.
PO BOX 187
FAISON, NC 28341-0187
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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