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DSH340061CK UNC Hospitals (Terminated)
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Main Details
Name
UNC Hospitals
Subdivision Name
UNC Hospitals Infusion at High Point
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH340061CK
Medicare Provider Number
340061
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
1/12/2017
Participating Start Date
4/1/2017
Participating Approval Date
3/3/2017
Last Recertification Date
11/6/2017
Termination Date
Termination Reason
10/1/2018
Site closure
Contacts
Authorizing Official
UNC Hospitals
Benjamin Rowell Daniels, Chief Operating Officer
(984) 974-7744
Primary Contact
UNC Hospitals
Jami Mann, Clinical Manager, Administrative Services
(984) 974-0085
Addresses
Street Address
302 Westwood Avenue
High Point, NC 27262
Billing Address
UNC Hospitals Pharmacy
4400 Emperor Blvd
Durham, NC 27703
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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