340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FORSYTH MEMORIAL HOSPITAL
DSH340014 Forsyth Memorial Hospital, Inc d/b/a Novant Health Forsyth Medical Center
Print
Covered Entity Details
Entity Name
Forsyth Memorial Hospital, Inc d/b/a Novant Health Forsyth Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340014
Entity Address
3333 SILAS CREEK PARKWAY
WINSTON-SALEM, NC 27103-3013
Medicare Provider Number
340014
Participating Start Date
7/1/2007
Last Recertification Date
9/6/2019
Entity Termination Date
7/7/2020
Pharmacy Details
Pharmacy Name
FORSYTH MEMORIAL HOSPITAL
Pharmacy Address
DBA NOVANT HEALTH PHARMACY
3333 SILAS CREEK PKWY
WINSTON SALEM, NC 27103-3013
Pharmacy Comments
Contract Details
Approval Date
10/28/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/7/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Sean M. Sanz, SVP & COO NHFMC
(336) 718-2029
Contract Pharmacy Representative
Novant Health Pharmacy Services, LLC
Jessica McDuffie, Supervisor Retail Pharmacy
(336) 277-8800
Signed By Date
10/28/2016
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