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DSH340069AA WAKEMED (Active)
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Main Details
Name
WAKEMED
Subdivision Name
WakeMed North Family Health & Women's Hospital - Post Procedural Care Unit
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340069AA
Medicare Provider Number
340069
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/15/2013
Participating Start Date
7/1/2016
Participating Approval Date
6/18/2013
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Wakemed
DONALD GINTZIG, President and CEO
(919) 350-8102
Primary Contact
Wakemed
Abbie Crisp Williamson, Executive Director of Pharmacy
(919) 350-8240
Addresses
Street Address
10000 Falls of Neuse Road
Raleigh, NC 27614
Billing Address
WakeMed North Family Health & Womens Hospital
Attn: Accounts Payable
PO Box 14549
Raleigh, NC 27620
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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5/18/16 Participated starting 7/1/2013, terminated 7/1/2014. Reinstated 7/1/2016.
05/18/2016
May 2025
May 2025
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