340B Drug Pricing Program Database
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DSH100038BM MEMORIAL REGIONAL HOSPITAL (Terminated)
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Main Details
Name
MEMORIAL REGIONAL HOSPITAL
Subdivision Name
Home Health Agency / Speech Therapy
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH100038BM
Medicare Provider Number
100038
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2016
Participating Start Date
4/1/2016
Participating Approval Date
3/8/2016
Last Recertification Date
8/30/2021
Termination Date
Termination Reason
10/1/2022
Business decision by the Covered Entity
Contacts
Authorizing Official
Memorial Healthcare System
Peter Powers, CEO, Memorial Regional Hospital
(954) 265-5814
Primary Contact
Memorial Healthcare System
Alexsandra Soto, Director, 340B Program
(954) 276-1771
Addresses
Street Address
7029 Taft Street
Hollywood, 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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