340B Drug Pricing Program Database
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DSH340113DA CAROLINAS MEDICAL CENTER (Active)
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Main Details
Name
CAROLINAS MEDICAL CENTER
Subdivision Name
Pediatric Outpatient Infusion Center CLIV
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340113DA
Medicare Provider Number
340113
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/13/2023
Participating Start Date
4/1/2023
Participating Approval Date
2/3/2023
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Atrium Health
Don McCoy Mabe, VP, Pharmacy
(704) 512-7623
Primary Contact
North Carolina Baptist Hospital
Bibi W Wishart, Program Director, 340B
(336) 713-3426
Addresses
Street Address
1001 Blythe Blvd
Suites 3400 and 3500
Charlotte, NC 28203
Billing Address
Atrium Health Accounts Payable
PO Box 516
Elmsford, NY 10523
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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