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DSH340008A SCOTLAND MEMORIAL HOSPITAL (Active)
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Main Details
Name
SCOTLAND MEMORIAL HOSPITAL
Subdivision Name
PEMBROKE FAMILY PRACTICE CENTER
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH340008A
Medicare Provider Number
340008
Outpatient Facility Provider Number
343982
Additional Details
Current Program Status
Active
Registration Date
10/9/2014
Participating Start Date
1/1/2015
Participating Approval Date
12/4/2014
Last Recertification Date
8/22/2024
Contacts
Authorizing Official
Scotland Memorial Hospital
Beatrice M Holt, Senior Vice President Patient Care Services
(910) 291-7531
Primary Contact
Scotland Health Care System
Claire W Graham, Director of Pharmacy
(910) 291-7782
Addresses
Street Address
412 S JONES ST
PEMBROKE, NC 28372
Billing Address
Pembroke Family Practice
PO Box 2257
Laurinburg, NC 28353-2257
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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