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ESI MAIL PHARMACY SERVICE
DSH340113 CAROLINAS MEDICAL CENTER
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Covered Entity Details
Entity Name
CAROLINAS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340113
Entity Address
1000 BLYTHE BLVD
CHARLOTTE, NC 28203
Medicare Provider Number
340113
Participating Start Date
8/1/1993
Last Recertification Date
9/4/2024
Pharmacy Details
Pharmacy Name
ESI MAIL PHARMACY SERVICE
Pharmacy Address
DBA EXPRESS SCRIPTS
7909 S HARDY DR STE 106
TEMPE, AZ 85284-1112
Pharmacy Comments
Contract Details
Approval Date
4/13/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Scott Leighty, Senior Vice President
(704) 512-2414
Contract Pharmacy Representative
Accredo
Casey Spiess, Director, 340B Business Development
(314) 486-5839
Signed By Date
4/13/2020
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