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REALO DISCOUNT DRUG
DSH340040 PITT COUNTY MEMORIAL HOSPITAL, INCORPORATED d/b/a ECU HEALTH MEDICAL CENTER
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Covered Entity Details
Entity Name
PITT COUNTY MEMORIAL HOSPITAL, INCORPORATED d/b/a ECU HEALTH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340040
Entity Address
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Medicare Provider Number
340040
Participating Start Date
4/1/2003
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
REALO DISCOUNT DRUG
Pharmacy Address
300 N QUEEN ST
KINSTON, NC 28501
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brian Floyd, PRESIDENT
(252) 847-5949
Contract Pharmacy Representative
Realo Discount Drug
Hardy W. Creech II, Vice President
(252) 527-6929
Signed By Date
7/17/2018
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