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DSH340061C UNC Hospitals (Terminated)
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Main Details
Name
UNC Hospitals
Subdivision Name
UNCH GERIATRIC SPECIALTY CLINIC
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH340061C
Medicare Provider Number
340061
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2013
Participating Start Date
7/1/2013
Participating Approval Date
6/11/2013
Last Recertification Date
8/19/2019
Termination Date
Termination Reason
7/1/2020
Hospital Outpatient facility no longer eligible
Contacts
Authorizing Official
UNC Hospitals
Benjamin Rowell Daniels, Chief Operating Officer
(984) 974-7744
Primary Contact
UNC Hospitals
Jami Mann, Clinical Manager, Administrative Services
(984) 974-0085
Addresses
Street Address
6011 Farrington Road
Suite 101
Chapel Hill, NC 27517
Billing Address
UNC Hospitals Pharmacy
4400 Emperor Blvd
Durham, NC 27703
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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per call from entity mistakenly terminated wrong child site, please reinstate child site status. did not have time to notify AO prior to his accepting
10/17/2016
April 2025
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