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DSH340096B LEXINGTON MEMORIAL HOSPITAL, INC. (Terminated)
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Main Details
Name
LEXINGTON MEMORIAL HOSPITAL, INC.
Subdivision Name
Women's Center of North Davidson
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH340096B
Medicare Provider Number
340096
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/11/2013
Participating Start Date
10/1/2013
Participating Approval Date
9/12/2013
Last Recertification Date
9/6/2016
Termination Date
Termination Reason
1/1/2018
Site closure
Contacts
Authorizing Official
Lexington Memorial Hospital, Inc.
DANNY SQUIRES, CFO
(336) 248-5161
Primary Contact
NORTH CAROLINA BAPTIST HOSPITAL
Martin Konopko, System Manager 340b
(336) 713-9418
Addresses
Street Address
799 Hickory Tree Road
Winston-Salem, NC 27127
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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June 2025
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