340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH420018R PRISMA HEALTH RICHLAND HOSPITAL (Terminated)
Print
Main Details
Name
PRISMA HEALTH RICHLAND HOSPITAL
Subdivision Name
PSC White Rock
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH420018R
Medicare Provider Number
420018
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/14/2013
Participating Start Date
4/1/2013
Participating Approval Date
2/28/2013
Last Recertification Date
9/10/2020
Termination Date
Termination Reason
10/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Prisma Health Richland Hospital
Robert Haarbauer Cofield, Chief Executive Officer
(803) 434-3750
Primary Contact
Prisma Health
Jennifer Davis Bair, Director of Pharmacy
(803) 434-3769
Addresses
Street Address
PSC White Rock
109 Wartburg Road
White Rock, SC 29177
Billing Address
Prisma Health SeniorCare Pharmacy
1308 Laurel Street
2nd Floor
Columbia, SC 29201
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
June 2025
June 2025
week
S
M
T
W
T
F
S
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
24
8
9
10
11
12
13
14
25
15
16
17
18
19
20
21
26
22
23
24
25
26
27
28
27
29
30
1
2
3
4
5
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session