340B Drug Pricing Program Database
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RWI33021 Memorial Division of Infectious Disease (Active)
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Main Details
Name
Memorial Division of Infectious Disease
Subdivision Name
Type
Ryan White Part A
340B ID
RWI33021
Grant Number
H89HA000023500
Additional Details
Current Program Status
Active
Registration Date
7/8/2019
Participating Start Date
10/1/2019
Participating Approval Date
8/8/2019
Last Recertification Date
2/28/2025
Time Period the Assistance was Received
3/1/2025 - 2/28/2026
Contacts
Authorizing Official
Memorial Regional Hospital
AURELIO FERNANDEZ, CEO
(954) 265-5014
Primary Contact
Memorial Healthcare System
Alexsandra Soto, Director, 340B Program
(954) 276-1771
Addresses
Street Address
5647 Hollywood Boulevard
Hollywood, FL 33021
Billing Address
Memorial Division of Infectious Disease
PO BOX 538500
Atlanta, GA 30353-8500
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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