Covered Entity Details

DSH440084C SWEETWATER HOSPITAL ASSOCIATION (Terminated) - information as of 4/30/2025 10:49:56 PM

Main Details

Name

SWEETWATER HOSPITAL ASSOCIATION

Subdivision Name

SWEETWATER HOSPITAL ASSOCIATION - Urgent Care

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH440084C

Medicare Provider Number

440084

Outpatient Facility Provider Number

Additional Details

Current Program Status

Terminated

Registration Date

1/12/2024

Participating Start Date

4/1/2024

Participating Approval Date

3/6/2024

Last Recertification Date

Termination Date
Termination Reason

7/1/2024
Site closure

Contacts

Authorizing Official

Sweetwater Hospital Associaton
Ashley Gail Shamblin, Chief Financial Officer
(865) 213-8582

Primary Contact

Sweetwater Hospital Association
Julie Anderson, 340b Manager
(865) 213-8506

Addresses

Street Address

2041 HIGHWAY 411
VONORE, TN 37885-2515

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH440084A	Child	DSH	SWEETWATER HOSPITAL ASSOCIATION	SWEETWATER HOSPITAL ASSOCIATION - Primary Care	901 GROVE ST	LOUDON	TN	Terminated
DSH440084B	Child	DSH	SWEETWATER HOSPITAL ASSOCIATION	SWEETWATER HOSPITAL ASSOCIATION - Primary Care	321 TELLICO ST S	MADISONVILLE	TN	Active
DSH440084C	Child	DSH	SWEETWATER HOSPITAL ASSOCIATION	SWEETWATER HOSPITAL ASSOCIATION - Urgent Care	2041 HIGHWAY 411	VONORE	TN	Terminated

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Authorizing Official	Update	Profile Change Request	Votruba, Ashley Gail Chief Financial Officer Sweetwater Hospital Associaton 8652138582	Shamblin, Ashley Gail Chief Financial Officer Sweetwater Hospital Associaton 8652138582	3/11/2025 11:08 AM
Contacts	Signed By	Update	Profile Change Request	Votruba, Ashley Gail Chief Financial Officer Sweetwater Hospital Associaton 8652138582	Shamblin, Ashley Gail Chief Financial Officer Sweetwater Hospital Associaton 8652138582	3/11/2025 11:08 AM
Contacts	Primary Contact	Update	Profile Change Request	Anderson, Julie 340b Manager Sweetwater Hospital Association 8652138529	Anderson, Julie 340b Manager Sweetwater Hospital Association 8652138506	2/25/2025 12:23 PM
Details	State	Update		To Be Terminated	Terminated	7/1/2024 12:01 AM
Dates	Last Date That 340B Drugs Purchased	Update	Termination Request		4/1/2024 12:00:00 AM	4/4/2024 10:50 AM
Details	State	Update	Termination Request	Active	To Be Terminated	4/4/2024 10:50 AM
Terminations	Termination Comments	Update	Termination Request		This child site is not longer open for business.	4/4/2024 10:50 AM
Terminations	Termination Date	Update	Termination Request		7/1/2024 12:00:00 AM	4/4/2024 10:50 AM
Terminations	Termination Effective Date	Update	Termination Request		4/1/2024 12:00:00 AM	4/4/2024 10:50 AM
Terminations	Termination Reason	Update	Termination Request		Site closure	4/4/2024 10:50 AM
Details	State	Update		Approved	Active	4/1/2024 12:01 AM
Contacts	Signed By	Insert	New Registration		Votruba, Ashley Gail Chief Financial Officer Sweetwater Hospital Associaton 8652138582	3/6/2024 12:57 PM
Details	340B ID	Update	New Registration		DSH440084C	3/6/2024 12:57 PM
Details	Entity Subname	Update	New Registration	SWEETWATER HOSPITAL ASSOCIATION	SWEETWATER HOSPITAL ASSOCIATION - Urgent Care	3/6/2024 12:57 PM
Dates	Participating Approval Date	Update	New Registration		3/6/2024 12:57:42 PM	3/6/2024 12:57 PM
Details	State	Update	New Registration	Pending	Approved	3/6/2024 12:57 PM
Dates	Signed By Date	Update	New Registration		2/2/2024 9:16:22 AM	3/6/2024 12:57 PM
Dates	Start Date	Update	New Registration		4/1/2024 12:00:00 AM	3/6/2024 12:57 PM
Addresses	Main Address	Insert	New Registration		2041 HIGHWAY 411 VONORE, TN 37885-2515	1/12/2024 5:14 PM
Contacts	Authorizing Official	Insert	New Registration		Votruba, Ashley Gail Chief Financial Officer Sweetwater Hospital Associaton 8652138582	1/12/2024 5:14 PM
Contacts	Primary Contact	Insert	New Registration		Anderson, Julie 340b Manager Sweetwater Hospital Association 8652138529	1/12/2024 5:14 PM
Details	Assistance Received From Date	Insert	New Registration			1/12/2024 5:14 PM
Details	Assistance Received To Date	Insert	New Registration			1/12/2024 5:14 PM
Details	Last Recertification Date	Insert	New Registration			1/12/2024 5:14 PM
Details	Grant Number	Insert	New Registration			1/12/2024 5:14 PM
Details	340B ID	Insert	New Registration			1/12/2024 5:14 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/12/2024 5:14 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/12/2024 5:14 PM
Details	Medicare Provider Number	Insert	New Registration		440084	1/12/2024 5:14 PM
Details	Entity Name	Insert	New Registration		SWEETWATER HOSPITAL ASSOCIATION	1/12/2024 5:14 PM
Details	NOFO Number	Insert	New Registration			1/12/2024 5:14 PM
Details	Program Code	Insert	New Registration		DSH	1/12/2024 5:14 PM
Details	Entity Subname	Insert	New Registration		SWEETWATER HOSPITAL ASSOCIATION	1/12/2024 5:14 PM
Dates	Participating Approval Date	Insert	New Registration			1/12/2024 5:14 PM
Details	State	Insert	New Registration		Pending	1/12/2024 5:14 PM
Dates	Registration Date	Insert	New Registration		1/12/2024 5:14:50 PM	1/12/2024 5:14 PM
Dates	Signed By Date	Insert	New Registration			1/12/2024 5:14 PM
Dates	Start Date	Insert	New Registration			1/12/2024 5:14 PM
Terminations	Termination Comments	Insert	New Registration			1/12/2024 5:14 PM
Terminations	Termination Date	Insert	New Registration			1/12/2024 5:14 PM
Terminations	Termination Effective Date	Insert	New Registration			1/12/2024 5:14 PM
Terminations	Termination Reason	Insert	New Registration			1/12/2024 5:14 PM