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DSH340127D GRANVILLE MEDICAL CENTER (Terminated)
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Main Details
Name
GRANVILLE MEDICAL CENTER
Subdivision Name
Granville Heart & Vascular
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340127D
Medicare Provider Number
340127
Outpatient Facility Provider Number
340127
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2014
Participating Start Date
10/1/2014
Participating Approval Date
9/15/2014
Last Recertification Date
9/2/2016
Termination Date
Termination Reason
1/1/2018
Site closure
Contacts
Authorizing Official
Granville Health System
Adam West McConnell, CEO
(919) 690-3402
Primary Contact
Granville Health System
Jeffery M. Armstrong, CFO
(919) 690-3402
Addresses
Street Address
102 Professional Park Drive, Suite C
Oxford, NC 27565
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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