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CH04580AF GOSHEN MEDICAL CENTER, INC. (Terminated)
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Main Details
Name
GOSHEN MEDICAL CENTER, INC.
Subdivision Name
GOSHEN MEDICAL CENTER - VINELAND
Type
HRSA-Funded Health Center
Site ID
BPS-H80-018861
340B ID
CH04580AF
Grant Number
H80CS00181
Additional Details
Current Program Status
Terminated
Registration Date
4/4/2017
Participating Start Date
7/1/2017
Participating Approval Date
5/15/2017
Last Recertification Date
2/4/2021
Termination Date
Termination Reason
4/1/2021
Site closure
Contacts
Authorizing Official
Goshen Medical Center, Inc.
Erich Koch, Finance Director
(910) 267-1942 Ext: 1127
Primary Contact
Goshen Medical Center, Inc.
Heather Lynette Maynor, Director of Pharmacy
(910) 718-5200 Ext: 1380
Addresses
Street Address
630 S Madison Street
Whiteville, NC 28472-4130
Billing Address
Goshen Medical Center, Inc.
PO Box 187
Faison, NC 28341-0187
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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