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CAH341315-05 Bladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County Hospital (Active)
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Main Details
Name
Bladen Healthcare, LLC DBA Cape Fear Valley Health System - Bladen County Hospital
Subdivision Name
CFV BLADEN MEDICAL ASSOCIATES - Family medicine practice
Type
Critical Access Hospital
Rural
Yes
340B ID
CAH341315-05
Medicare Provider Number
341315
Outpatient Facility Provider Number
343464
Additional Details
Current Program Status
Active
Registration Date
10/8/2018
Participating Start Date
1/1/2019
Participating Approval Date
11/30/2018
Last Recertification Date
8/16/2024
Contacts
Authorizing Official
Bladen County Hospital
Spencer Lowell Cummings, President
(910) 862-5149
Primary Contact
Bladen Healthcare, LLC dba CFVHS-Bladen County Hospital
Karen Gentry, Pharmacy Director
(910) 862-5157
Addresses
Street Address
9858 WR Lathan Drive
CLARKTON, NC 28433-5003
Billing Address
CFVH Bladen Medical Associate Clarkton
PO Box 54
Clarkton, NC 28433
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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