340B Drug Pricing Program Database
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DSH100281L MEMORIAL HOSPITAL WEST (Active)
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Main Details
Name
MEMORIAL HOSPITAL WEST
Subdivision Name
MCI Infusion MHW
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100281L
Medicare Provider Number
100281
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/15/2015
Participating Start Date
1/1/2016
Participating Approval Date
10/26/2015
Last Recertification Date
8/12/2024
Contacts
Authorizing Official
Memorial Hospital West
JOSEPH STUCZYNSKI, CEO
(954) 844-6871
Primary Contact
Memorial Healthcare System
Alexsandra Soto, Director, 340B Program
(954) 276-1771
Addresses
Street Address
Memorial Hospital West 3West Nursing Unit
703 N. Flamingo Rd
Pembroke Pines, FL 33028
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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June 2025
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