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GUILFORD CO HLTH DEPT PHCY
DSH340091 THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
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Covered Entity Details
Entity Name
THE MOSES H CONE MEMORIAL HOSPITAL OPERATING CORPORATION
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340091
Entity Address
1200 NORTH ELM STREET
GREENSBORO, NC 27401-1020
Medicare Provider Number
340091
Participating Start Date
4/1/2006
Last Recertification Date
8/30/2024
Pharmacy Details
Pharmacy Name
GUILFORD CO HLTH DEPT PHCY
Pharmacy Address
1100 E WENDOVER AVE
GREENSBORO, NC 27405-6713
Pharmacy Comments
Contract Details
Approval Date
11/9/2012
Contract Begin Date
1/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/12/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brian Romig, Vice President of Pharmacy Services and Supply Chain
(336) 832-7807
Contract Pharmacy Representative
Guilford County Heath Dept Pharmacy
Mary Elizabeth Batten, Director of Pharmacy
(336) 641-8329
Signed By Date
10/3/2012
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