340B Drug Pricing Program Database
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DSH420051N MCLEOD REGIONAL MEDICAL CENTER (Active)
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Main Details
Name
MCLEOD REGIONAL MEDICAL CENTER
Subdivision Name
MRMC OF THE PEE DEE SURGERY CENTER - Outpatient Surgery
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH420051N
Medicare Provider Number
420051
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/8/2019
Participating Start Date
7/1/2019
Participating Approval Date
4/22/2019
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
McLeod Health
Christian Soura, Chief Financial Officer
(843) 777-5492
Primary Contact
McLeod Health
Hattie K. Hyman, PharmD, Pharmacy 340B Manager
(843) 777-5019
Addresses
Street Address
1005 E CHEVES ST
FLORENCE, SC 29506-2707
Billing Address
McLeod Regional Medical Center
555 East Cheves Street
Florence, SC 29506
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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