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REALO SPECIALTY CARE PHARMACY, INC
RRC340115-29 FIRSTHEALTH MOORE REGIONAL HOSPITAL
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Covered Entity Details
Entity Name
FIRSTHEALTH MOORE REGIONAL HOSPITAL
Subdivision Name
FirstHealth Outpatient Infectious Disease Clinic
Type
Rural Referral Center
340B ID
RRC340115-29
Entity Address
35 Memorial Drive
Pinehurst, NC 28374
Medicare Provider Number
340115
Outpatient Facility Provider Number
Participating Start Date
4/15/2020
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
REALO SPECIALTY CARE PHARMACY, INC
Pharmacy Address
860 AVIATION PKWY STE 1400
MORRISVILLE, NC 27560
Pharmacy Comments
Contract Details
Approval Date
1/5/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JEFF CASEY, VICE PRESIDENT OF FINANCE
(910) 715-1561
Contract Pharmacy Representative
Realo Specialty Care Pharmacy
Will Holland, Director of Sales and Business Development
(844) 814-1943
Signed By Date
1/5/2021
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