340B Drug Pricing Program Database
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DSH100285B MEMORIAL HOSPITAL MIRAMAR (Active)
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Main Details
Name
MEMORIAL HOSPITAL MIRAMAR
Subdivision Name
MSC Pre-OP/PACU - MHM MOB II RECOVERY ROOM
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH100285B
Medicare Provider Number
100285
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/12/2023
Participating Start Date
1/1/2024
Participating Approval Date
10/17/2023
Last Recertification Date
8/13/2024
Contacts
Authorizing Official
Memorial Hospital Miramar
Stephen L Demers, CEO
(954) 538-4800
Primary Contact
Memorial Healthcare System
Alexsandra Soto, Director, 340B Program
(954) 276-1771
Addresses
Street Address
1971 SW 172nd Avenue
Miramar, FL 33029
Billing Address
Memorial Healthcare System
Attn: Accounts Payable
PO BOX 269001
Pembroke Pines, FL 33026
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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