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REALO DISCOUNT DRUG STORES OF PINK HILL,
DSH340120 DUPLIN GENERAL HOSPITAL, INC. D/B/A ECU HEALTH DUPLIN HOSPITAL
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Covered Entity Details
Entity Name
DUPLIN GENERAL HOSPITAL, INC. D/B/A ECU HEALTH DUPLIN HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340120
Entity Address
401 NORTH MAIN STREET
KENANSVILLE, NC 28349
Medicare Provider Number
340120
Participating Start Date
7/1/2004
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
REALO DISCOUNT DRUG STORES OF PINK HILL,
Pharmacy Address
107 W BROADWAY ST
PINK HILL, NC 28572-7998
Pharmacy Comments
Contract Details
Approval Date
7/19/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
LUCINDA CRAWFORD, VICE PRESIDENT OF FINANCIAL SERVICES
(910) 296-2608
Contract Pharmacy Representative
Realo
Michael G. Wiggins, President
(252) 568-3161
Signed By Date
7/19/2018
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