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REALO DISCOUNT DRUG STORES OF EASTERN NO
DSH340040 PITT COUNTY MEMORIAL HOSPITAL, INCORPORATED d/b/a ECU HEALTH MEDICAL CENTER
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Covered Entity Details
Entity Name
PITT COUNTY MEMORIAL HOSPITAL, INCORPORATED d/b/a ECU HEALTH MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340040
Entity Address
2100 STANTONSBURG RD
GREENVILLE, NC 27834
Medicare Provider Number
340040
Participating Start Date
4/1/2003
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
REALO DISCOUNT DRUG STORES OF EASTERN NO
Pharmacy Address
D B A REALO EXTENDED CARE PHARMACY
2500 TRENT RD STE 40
TRENT VILLAGE SHOP CTN
NEW BERN, NC 28562-2008
Pharmacy Comments
Contract Details
Approval Date
1/12/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Brian Floyd, President
(252) 847-5949
Contract Pharmacy Representative
Realo Drug
Robert Rawls, Contract Pharmacy Rep
(910) 298-3093
Signed By Date
1/12/2024
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