340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SOUTH BROWARD HOSPITAL DISTRICT
DSH100038D MEMORIAL REGIONAL HOSPITAL
Print
Covered Entity Details
Entity Name
MEMORIAL REGIONAL HOSPITAL
Subdivision Name
BREAST CANCER CENTER AT MEMORIAL REGIONAL HOSPITAL / BREAST ONC PHYSICIANS
Type
Disproportionate Share Hospital
340B ID
DSH100038D
Entity Address
1150 NORTH 35TH AVE
SUITE #170
HOLLYWOOD, FL 33021
Medicare Provider Number
100038
Outpatient Facility Provider Number
Participating Start Date
7/1/2005
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
SOUTH BROWARD HOSPITAL DISTRICT
Pharmacy Address
MEMORIAL WEST OUTPATIENT PHARMACY
601 N FLAMINGO RD STE 110
PEMBROKE PINES, FL 33028-1007
Pharmacy Comments
Contract Details
Approval Date
2/26/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
4/1/2020
Contract Comments
Contacts
Covered Entity Signing Official
Judy Lynne Frum, COO
(954) 265-4105
Contract Pharmacy Representative
Memorial Healthcare System
Dorinda Segovia, Vice President of Pharmacy Services
(954) 276-1770
Signed By Date
2/26/2020
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session