340B Drug Pricing Program Database
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DSH100230B MEMORIAL HOSPITAL PEMBROKE (Active)
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Main Details
Name
MEMORIAL HOSPITAL PEMBROKE
Subdivision Name
South Broward Community Health Services - Pembroke Pines
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100230B
Medicare Provider Number
100230
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/7/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/12/2014
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Memorial Hospital Pembroke
Felicia Cephus Turnley, Chief Executive Officer
(954) 883-8482
Primary Contact
Memorial Healthcare System
Alexsandra Soto, Director, 340B Program
(954) 276-1771
Addresses
Street Address
2217 North University Drive
Pembroke Pines, FL 33024
Billing Address
Memorial Healthcare System
PO Box 269001
Attn: Accounts Payable
Pembroke Pines, FL 33026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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