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BAPTIST HOSPITAL SPECIALTY RX
DSH340004 HIGH POINT REGIONAL HEALTH
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Covered Entity Details
Entity Name
HIGH POINT REGIONAL HEALTH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340004
Entity Address
601 North Elm Street
High Point, NC 27262
Medicare Provider Number
340004
Participating Start Date
3/15/2022
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
BAPTIST HOSPITAL SPECIALTY RX
Pharmacy Address
NORTH TOWER GROUND FLOOR
MEDICAL CENTER BLVD
WINSTON SALEM, NC 27157
Pharmacy Comments
Contract Details
Approval Date
5/5/2023
Contract Begin Date
7/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Edwin Smith, Vice President, Chief Operating Officer
(336) 781-2181
Contract Pharmacy Representative
North Carolina Baptist Hospital
Bibi W Wishart, Program Director, 340B
(336) 713-3426
Signed By Date
5/5/2023
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