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MUSC MAIL ORDER PHARMACY
DSH420091 MUSC Health Florence Medical Center
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Covered Entity Details
Entity Name
MUSC Health Florence Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH420091
Entity Address
805 PAMPLICO HIGHWAY
FLORENCE, SC 29505
Medicare Provider Number
420091
Participating Start Date
1/1/2020
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
MUSC MAIL ORDER PHARMACY
Pharmacy Address
MARVA WILLIAMS-LOWE, PHARMD
2070 SAM RITTENBERG BLVD UNIT A116
CHARLESTON, SC 29407
Pharmacy Comments
Contract Details
Approval Date
4/14/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2023
Agreement registered in error
Contacts
Covered Entity Signing Official
Lisa Goodlett, Chief Financial Officer
(843) 792-4775
Contract Pharmacy Representative
Medical University Hospital Authority
Marv Williams-Lowe, Chief Pharmacy Officer
(843) 792-5691
Signed By Date
4/14/2023
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