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WINTER PARK DISCOUNT DRUG NILKANTH INC
DSH340141 Novant Health New Hanover Regional Medical Center
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Covered Entity Details
Entity Name
Novant Health New Hanover Regional Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340141
Entity Address
2131 South 17th Street
Attn: Pharmacy
Wilmington, NC 28401
Medicare Provider Number
340141
Participating Start Date
10/1/2003
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WINTER PARK DISCOUNT DRUG NILKANTH INC
Pharmacy Address
DBA WINTER PARK DISCOUNT DRUGS
5220 WRIGHTSVILLE AVE
WILMINGTON, NC 28403-7056
Pharmacy Comments
Contract Details
Approval Date
1/20/2021
Contract Begin Date
1/20/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Laurie Whalin, VP of Clinical Support Services
(910) 667-7731
Contract Pharmacy Representative
Robalo Pharmacy
Nirav Patel, Vice President
(561) 844-1191
Signed By Date
1/20/2021
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