340B Drug Pricing Program Database
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DSH340113AB CAROLINAS MEDICAL CENTER (Terminated)
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Main Details
Name
CAROLINAS MEDICAL CENTER
Subdivision Name
Atrium Health Transplant Center - Heart
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340113AB
Medicare Provider Number
340113
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
9/18/2012
Participating Start Date
10/1/2012
Participating Approval Date
9/19/2012
Last Recertification Date
9/14/2022
Termination Date
Termination Reason
10/1/2023
Business decision by the Covered Entity
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
1025 Morehead Medical Drive
Suite 600
Charlotte, NC 28204
Billing Address
Atrium Health Accounts Payable
PO Box 516
Elmsford, NY 10523
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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