340B Drug Pricing Program Database
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DSH340069H WAKEMED (Active)
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Main Details
Name
WAKEMED
Subdivision Name
WakeMed Physician Practices Gastroenterology Raleigh
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340069H
Medicare Provider Number
340069
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/14/2015
Participating Start Date
1/1/2016
Participating Approval Date
11/20/2015
Last Recertification Date
8/14/2024
Contacts
Authorizing Official
Wakemed
DONALD GINTZIG, President and CEO
(919) 350-8102
Primary Contact
Wakemed
Abbie Crisp Williamson, Executive Director of Pharmacy
(919) 350-8240
Addresses
Street Address
3024 New Bern Avenue
Andrews Center, 1st Floor
Raleigh, NC 27610
Billing Address
WakeMed Physician Practices Gastroenterology Raleigh
Attn: Accounts Payable
PO Box 14549
Raleigh, NC 27620
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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