340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FORSYTH MEMORIAL HOSPITAL
DSH340053 Presbyterian Hospital, d/b/a Novant Health Presbyterian Medical Center
Print
Covered Entity Details
Entity Name
Presbyterian Hospital, d/b/a Novant Health Presbyterian Medical Center
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH340053
Entity Address
200 HAWTHORNE LANE
CHARLOTTE, NC 28204
Medicare Provider Number
340053
Participating Start Date
4/1/2008
Last Recertification Date
8/23/2024
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
4/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Paula Vincent, President and COO, Presbyterian Medical Center
(704) 384-9656
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