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DSH340069AV WAKEMED (Active)
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Main Details
Name
WAKEMED
Subdivision Name
WakeMed Garner Healthplex - CV Testing EKG
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340069AV
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
12/1/2015
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
400 US Highway 70 East
Garner, NC 27529
Billing Address
WakeMed Garner Healthplex
Attn: Accounts Payable
PO Box 14549
Raleigh, NC 27620
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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