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DSH420051C MCLEOD REGIONAL MEDICAL CENTER (Terminated)
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Main Details
Name
MCLEOD REGIONAL MEDICAL CENTER
Subdivision Name
RSV Clinic
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH420051C
Medicare Provider Number
420051
Outpatient Facility Provider Number
420051
Additional Details
Current Program Status
Terminated
Registration Date
7/8/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/15/2013
Last Recertification Date
9/7/2021
Termination Date
Termination Reason
10/1/2022
Outpatient facility moved within the 4 walls of the parent hospital
Contacts
Authorizing Official
McLeod Health
S. Fulton Ervin, III, Senior Vice President Finance and Chief Financial Officer
(843) 777-2917
Primary Contact
McLeod Health
Hattie K. Hyman, PharmD, Pharmacy 340B Manager
(843) 777-5019
Addresses
Street Address
101 William H Johnson Street, Suite 400
Florence, SC 29506
Billing Address
McLeod Regional Medical Center
555 East Cheves Street
Florence, SC 29506
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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