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MEDICAL ARTS PHARMACY OF LENOIR
SCH340051-00 WATAUGA MEDICAL CENTER
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Covered Entity Details
Entity Name
WATAUGA MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH340051-00
Entity Address
336 DEERFIELD ROAD
BOONE, NC 28607
Medicare Provider Number
340051
Participating Start Date
3/15/2022
Last Recertification Date
9/3/2024
Entity Termination Date
7/1/2025
Pharmacy Details
Pharmacy Name
MEDICAL ARTS PHARMACY OF LENOIR
Pharmacy Address
328 MULBERRY ST SW
LENOIR, NC 28645
Pharmacy Comments
Contract Details
Approval Date
4/11/2013
Contract Begin Date
3/15/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kevin B. May, Chief Financial Officer
(828) 262-4119
Contract Pharmacy Representative
Dorothy Farfone, 340-b Director
(828) 964-6940
Signed By Date
4/11/2013
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