340B Drug Pricing Program Database
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DSH340069BK WAKEMED (Active)
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Main Details
Name
WAKEMED
Subdivision Name
WakeMed Raleigh Medical Park - HOPD Hematology & Oncology - Oncology
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH340069BK
Medicare Provider Number
340069
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2023
Participating Start Date
7/1/2023
Participating Approval Date
5/2/2023
Last Recertification Date
8/14/2024
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
23 Sunnybrook Rd
Suite 220
Raleigh, NC 27610
Billing Address
WakeMed Raleigh Medical Park
Attn: Accounts Payable
PO Box 14549
Raleigh, NC 27620
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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