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EXPRESS SCRIPTS PHARMACY, INC.
DSH340008 SCOTLAND MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
SCOTLAND MEMORIAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340008
Entity Address
500 LAUCHWOOD DRIVE
LAURINBURG, NC 28352
Medicare Provider Number
340008
Participating Start Date
7/1/2004
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
EXPRESS SCRIPTS PHARMACY, INC.
Pharmacy Address
DBA EXPRESS SCRIPTS
4750 E. 450 S.
WHITESTOWN, IN 46075
Pharmacy Comments
Contract Details
Approval Date
1/11/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David L Pope, Senior Vice President, Operations
(910) 291-7502
Contract Pharmacy Representative
Accredo Specialty Pharmacy
Gene McCabe, Lead Director, 340B Client Sales
(615) 943-7500
Signed By Date
1/11/2021
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