340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SOUTH BROWARD HOSPITAL DISTRICT
DSH100281M MEMORIAL HOSPITAL WEST
Print
Covered Entity Details
Entity Name
MEMORIAL HOSPITAL WEST
Subdivision Name
MCI WEST CYBERKNIFE
Type
Disproportionate Share Hospital
340B ID
DSH100281M
Entity Address
12235 Pines Blvd.
Pembroke Pines, FL 33026
Medicare Provider Number
100281
Outpatient Facility Provider Number
Participating Start Date
4/1/2016
Last Recertification Date
8/12/2024
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
LEAH CARPENTER, CEO
(954) 844-7500
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