340B Drug Pricing Program Database
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DSH340069BD WAKEMED (Active)
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Main Details
Name
WAKEMED
Subdivision Name
WakeMed Physician Practices Special Infant Care - Special Infant Care
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340069BD
Medicare Provider Number
340069
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
3/9/2020
Participating Start Date
4/1/2020
Participating Approval Date
3/13/2020
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Wakemed
DONALD GINTZIG, President and CEO
(919) 350-8102
Primary Contact
Wakemed
Abbie Crisp Williamson, Executive Director of Pharmacy
(919) 350-8240
Addresses
Street Address
3024 New Bern Ave
Andrews Center, 1st Floor
Raleigh, NC 27610
Billing Address
WakeMed Physician Practice Special Infant Care
Attn: Accounts Payable
P.O. Box 14549
Raleigh, NC 27620
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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