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DSH340028C CAPE FEAR VALLEY MEDICAL CENTER (Active)
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Main Details
Name
CAPE FEAR VALLEY MEDICAL CENTER
Subdivision Name
Cape Fear Valley Internal Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340028C
Medicare Provider Number
340028
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
2/29/2012
Participating Start Date
4/1/2012
Participating Approval Date
3/28/2012
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Cape Fear Valley Health
Bret David Johnson, Vice President and CFO
(910) 615-6378
Primary Contact
Cape Fear Valley Health System
Thomas Nicholson, Director of Pharmacy
(910) 615-6839
Addresses
Street Address
101 Robeson Street
Suite 300
Fayetteville, NC 28301
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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