340B Drug Pricing Program Database
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DSH340113CK CAROLINAS MEDICAL CENTER (Active)
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Main Details
Name
CAROLINAS MEDICAL CENTER
Subdivision Name
Levine Cancer Institute Palliative Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340113CK
Medicare Provider Number
340113
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/13/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/21/2016
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Atrium Health
Don McCoy Mabe, VP, Pharmacy
(704) 512-7623
Primary Contact
North Carolina Baptist Hospital
Bibi W Wishart, Program Director, 340B
(336) 713-3426
Addresses
Street Address
1021 Morehead Medical Dr
Suite 5100
Charlotte, NC 28204
Billing Address
Atrium Health Accounts Payable
PO Box 516
Elmsford, NY 10523
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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