340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
SOUTH BROWARD HOSPITAL DISTRICT
DSH100285B MEMORIAL HOSPITAL MIRAMAR
Print
Covered Entity Details
Entity Name
MEMORIAL HOSPITAL MIRAMAR
Subdivision Name
MSC Pre-OP/PACU - MHM MOB II RECOVERY ROOM
Type
Disproportionate Share Hospital
340B ID
DSH100285B
Entity Address
1971 SW 172nd Avenue
Miramar, FL 33029
Medicare Provider Number
100285
Outpatient Facility Provider Number
Participating Start Date
1/1/2024
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
SOUTH BROWARD HOSPITAL DISTRICT
Pharmacy Address
MEMORIAL REGIONAL HOSPITAL PRIMARY CARE
4105 PEMBROKE RD.
HOLLYWOOD, FL 33021
Pharmacy Comments
Contract Details
Approval Date
10/17/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Stephen L Demers, CEO
(954) 538-4800
Contract Pharmacy Representative
Memorial Healthcare System
Dorinda Segovia, Vice President of Pharmacy Services
(954) 276-1770
Signed By Date
10/16/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session