340B Drug Pricing Program Database
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DSH340014BF Forsyth Memorial Hospital, Inc d/b/a Novant Health Forsyth Medical Center (Terminated)
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Main Details
Name
Forsyth Memorial Hospital, Inc d/b/a Novant Health Forsyth Medical Center
Subdivision Name
Novant Health Kernersville Medical Center Operating Room
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340014BF
Medicare Provider Number
340014
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/13/2014
Participating Start Date
4/1/2014
Participating Approval Date
3/5/2014
Last Recertification Date
9/6/2019
Termination Date
Termination Reason
7/7/2020
DSH percentage below statutory minimum
Contacts
Authorizing Official
Novant Health
Geoffrey Gardner, SVP Finance
(336) 718-2078
Primary Contact
Novant Health
Elizabeth Anne Corazzo, Manager Pharmacy 340B
(336) 277-0301
Addresses
Street Address
1750 Kernersville Medical Parkway
Kernersville, NC 27284-7146
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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