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DSH340145D Atrium Health Lincoln (Terminated)
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Main Details
Name
Atrium Health Lincoln
Subdivision Name
Levine Cancer Institute Medical Oncology Clinic (330700)
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340145D
Medicare Provider Number
340145
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
7/14/2016
Participating Start Date
10/1/2016
Participating Approval Date
8/16/2016
Last Recertification Date
9/14/2020
Termination Date
Termination Reason
10/1/2021
DSH percentage below statutory minimum
Contacts
Authorizing Official
Atrium Health
Don McCoy Mabe, VP, Pharmacy
(704) 512-7623
Primary Contact
Atrium Health
Fern Paul-Aviles, AVP, Pharmacy
(704) 649-9691
Addresses
Street Address
447 McAlister Road
Suite 1600
Lincolnton, NC 28092
Billing Address
Atrium Health Accounts Payable
PO Box 5379
Portland, OR 97228-5379
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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