340B Drug Pricing Program Database
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DSH340113BG CAROLINAS MEDICAL CENTER (Active)
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Main Details
Name
CAROLINAS MEDICAL CENTER
Subdivision Name
Levine Cancer GU Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340113BG
Medicare Provider Number
340113
Outpatient Facility Provider Number
340113
Additional Details
Current Program Status
Active
Registration Date
7/12/2014
Participating Start Date
10/1/2014
Participating Approval Date
8/29/2014
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Atrium Health
Don McCoy Mabe, VP, Pharmacy
(704) 512-7623
Primary Contact
North Carolina Baptist Hospital
Bibi W Wishart, Program Director, 340B
(336) 713-3426
Addresses
Street Address
1021 Morehead Medical Drive
Suite 6100
Charlotte, NC 28204
Billing Address
Atrium Health Accounts Payable
PO Box 516
Elmsford, NY 10523
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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