340B Drug Pricing Program Database

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

Current Program Status

Active

Registration Date

2/29/2012

Participating Start Date

4/1/2012

Participating Approval Date

3/28/2012

Last Recertification Date

8/28/2023

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

Street Address

101 Robeson Street
Suite 300
Fayetteville, NC 28301

Billing Address
Same as Street Address