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CORAM ALTERNATE SITE SERVICES, INC.
CAH341327-00 J ARTHUR DOSHER MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
J ARTHUR DOSHER MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH341327-00
Entity Address
924 N HOWE ST
SOUTHPORT, NC 28461
Medicare Provider Number
341327
Participating Start Date
7/1/2011
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
CORAM ALTERNATE SITE SERVICES, INC.
Pharmacy Address
DBA CORAM CVS/SPECIALTY INFUSION SERVICE
507 AIRPORT BLVD.
SUITE 100
MORRISVILLE, NC 27560-8200
Pharmacy Comments
Contract Details
Approval Date
1/11/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/17/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
KELLIE VELEZ, CONTROLLER
(910) 457-3815
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/11/2024
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