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CENTERWELL 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
CENTERWELL PHARMACY, INC.
Pharmacy Address
10737 MARKS WAY
MIRAMAR, FL 33025
Pharmacy Comments
Contract Details
Approval Date
4/10/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/24/2024
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
Centerwell
Shelley Duke, Director, Specialty Pharmacy Contracting and Infusion
(502) 994-8732
Signed By Date
4/10/2021
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