Contract Pharmacy Details

ATRIUM HEALTH AT HOME INFUSION AND EQUIP
DSH340113 CAROLINAS MEDICAL CENTER

Covered Entity Details

Entity Name

CAROLINAS MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH340113

Entity Address

1000 BLYTHE BLVD
CHARLOTTE, NC 28203

Medicare Provider Number

340113

Participating Start Date

8/1/1993

Last Recertification Date

9/4/2024

Pharmacy Details

Pharmacy Name

ATRIUM HEALTH AT HOME INFUSION AND EQUIP

Pharmacy Address

1701 ABBEY PL
CHARLOTTE, NC 28209-3733

Pharmacy Comments

Contract Details

Approval Date

4/18/2012

Contract Begin Date

4/18/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/1/2024
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Greg Gombar, Chief Financial Officer
(704) 355-2154

Contract Pharmacy Representative

Connie Bonebrake, Vice President
(704) 512-2311

Signed By Date

4/10/2012

340B Drug Pricing Program Database