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DSH340127B GRANVILLE MEDICAL CENTER (Active)
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Main Details
Name
GRANVILLE MEDICAL CENTER
Subdivision Name
SOUTH GRANVILLE PRIMARY CARE
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340127B
Medicare Provider Number
340127
Outpatient Facility Provider Number
340127
Additional Details
Current Program Status
Active
Registration Date
7/11/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/15/2014
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Granville Health System
Adam West McConnell, CEO
(919) 690-3402
Primary Contact
Granville Health System
Lynda Wrenn Beasley, Interim Director of Pharmacy
(919) 690-3000 Ext: 3471
Addresses
Street Address
1614 NC Highway 56
Creedmoor, NC 27522-8297
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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