Covered Entity Details

RRC440025-00 LAUGHLIN MEMORIAL HOSPITAL, INC. (Terminated) - information as of 5/9/2025 12:13:05 AM

Main Details

Name

LAUGHLIN MEMORIAL HOSPITAL, INC.

Subdivision Name

Type

Rural Referral Center

Rural

Yes

340B ID

RRC440025-00

Medicare Provider Number

440025

Additional Details

Current Program Status

Terminated

Registration Date

1/7/2013

Participating Start Date

4/1/2013

Participating Approval Date

1/14/2013

Last Recertification Date

8/16/2016

Termination Date
Termination Reason

1/1/2018
DSH percentage below statutory minimum

Contacts

Authorizing Official

Laughlin Memorial Hospital
JOHN MARK COMPTON, CFO
(423) 787-5077

Primary Contact

Laughlin Memorial Hospital
JOHN MARK COMPTON, CFO
(423) 787-5077

Addresses

Street Address

1420 TUSCULUM BLVD.
GREENEVILLE, TN 37745-5825

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?
Yes

State	Medicaid Number	NPI Number
TN	0440025
		1881669778

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Termination Date	Last Updated On
Contract Detail	ASHEVILLE HIGHWAY PHARMACY, INC.	D/B/A ATCHLEY DRUG CENTER	511 ASHEVILLE HWY	GREENEVILLE	TN	37743	10/07/2013	01/01/2014	01/01/2018	01/01/2018
Contract Detail	CENTRAL DRUG STORE	239 W SUMMER ST		GREENEVILLE	TN	37743-4925	07/01/2016	10/01/2016	01/01/2018	01/01/2018
Contract Detail	CORLEY'S PHARMACY INC	1004 SNAPPS FERRY RD	PO BOX 874	GREENEVILLE	TN	37744-0874	10/01/2013	01/01/2014	01/01/2018	01/01/2018
Contract Detail	CVS TN DISTRIBUTION, LLC	10017 KINGSTON PIKE		KNOXVILLE	TN	37922	10/07/2014	01/01/2015	01/01/2018	01/01/2018
Contract Detail	FOOD CITY PHARMACY #606	905 SNAPPS FERRY ROAD		GREENEVILLE	TN	37745	01/04/2016	04/01/2016	01/01/2018	01/01/2018
Contract Detail	FOOD CITY PHARMACY #663	2755 E. ANDREW JOHNSON HIGHWAY		GREENEVILLE	TN	37745	04/01/2014	07/01/2014	01/01/2018	01/01/2018
Contract Detail	TENNESSEE CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03725	837 TUSCULUM BLVD	GREENEVILLE	TN	37745	10/07/2013	01/01/2014	01/01/2018	01/01/2018
Contract Detail	TENNESSEE CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03791	1510 E. ANDREW JOHNSON HWY.	GREENEVILLE	TN	37745	10/07/2013	01/01/2014	09/16/2016	01/30/2017
Contract Detail	TENNESSEE CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07738	506 ASHEVILLE HWY	GREENEVILLE	TN	37743	10/07/2013	01/01/2014	09/16/2016	01/30/2017
Contract Detail	TOWN & COUNTRY PHARMACY	910 TUSCULUM BLVD		GREENEVILLE	TN	37745	07/17/2017	10/01/2017	01/01/2018	01/01/2018
Contract Detail	WAL-MART PHARMACY 10-0680	3755 E. ANDREW JOHNSON HWY		GREENVILLE	TN	37745	10/02/2014	01/01/2015	10/22/2015	01/04/2016

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
No records to display.

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		To Be Terminated	Terminated	1/1/2018 12:00 AM
Dates	Last Date That 340B Drugs Purchased	Update	Recertification		11/29/2017 12:00:00 AM	11/29/2017 10:24 PM
Details	State	Update	Recertification	Active	To Be Terminated	11/29/2017 10:24 PM
Terminations	Termination Comments	Update	Recertification		FY17 cost report being processed for filing on 11/30/17 will have DSH % below 8%	11/29/2017 10:24 PM
Terminations	Termination Date	Update	Recertification		1/1/2018 12:00:00 AM	11/29/2017 10:24 PM
Terminations	Termination Effective Date	Update	Recertification		11/29/2017 12:00:00 AM	11/29/2017 10:24 PM
Terminations	Termination Reason	Update	Recertification		DSH percentage below statutory minimum	11/29/2017 10:24 PM
Contacts	Authorizing Official	Update		COMPTON, JOHN MARK CFO 4237875077	COMPTON, JOHN MARK CFO Laughlin Memorial Hospital 4237875077	10/16/2017 10:10 AM
Contacts	Primary Contact	Update		COMPTON, JOHN MARK CFO 4237875077	COMPTON, JOHN MARK CFO Laughlin Memorial Hospital 4237875077	10/16/2017 10:10 AM
Contacts	Signed By	Update		COMPTON, JOHN MARK CFO 4237875077	COMPTON, JOHN MARK CFO Laughlin Memorial Hospital 4237875077	10/16/2017 10:10 AM
Contacts	Authorizing Official	Insert			COMPTON, JOHN MARK CFO 4237875077	7/17/2017 2:57 PM
Contacts	Primary Contact	Insert			COMPTON, JOHN MARK CFO 4237875077	7/17/2017 2:57 PM
Contacts	Signed By	Insert			COMPTON, JOHN MARK CFO 4237875077	7/17/2017 2:57 PM
Addresses	Main Address	Insert			1420 TUSCULUM BLVD. GREENEVILLE, TN 37745-5825	8/16/2016 8:13 AM
Details	Last Recertification Date	Update		8/6/2015 12:00:00 AM	8/16/2016 12:00:00 AM	8/16/2016 8:13 AM
Details	Last Recertification Date	Update		8/11/2014 12:00:00 AM	8/6/2015 12:00:00 AM	8/6/2015 1:40 PM
Details	Last Recertification Date	Update		9/7/2013 9:38:46 AM	8/11/2014 12:00:00 AM	8/11/2014 2:49 PM
Details	Last Recertification Date	Update			9/7/2013 9:38:46 AM	9/7/2013 9:38 AM
Details	340B ID	Update		IS FF RRC440025	RRC440025-00	1/14/2013 1:43 PM
Dates	Participating Approval Date	Update			1/14/2013 12:00:00 AM	1/14/2013 1:43 PM
Details	State	Update		Pending	Active	1/14/2013 1:43 PM
Dates	Start Date	Update			4/1/2013 12:00:00 AM	1/14/2013 1:43 PM
Details	340B ID	Update		FF010713A	IS FF RRC440025	1/10/2013 4:27 PM
Details	340B ID	Update		RRC010713	FF010713A	1/7/2013 7:06 PM
Details	340B ID	Update		ONLINE_REG	RRC010713	1/7/2013 7:03 PM
Medicaid Billing	Medicaid: Is Primary	Insert			False	1/7/2013 9:24 AM
Medicaid Billing	Medicaid: Number	Insert			0440025	1/7/2013 9:24 AM
Medicaid Billing	Medicaid: State	Insert			TN	1/7/2013 9:24 AM
Medicaid Billing	NPI: Number	Insert			1881669778	1/7/2013 9:24 AM
Details	Last Recertification Date	Insert				1/7/2013 9:24 AM
Details	Grant Number	Insert				1/7/2013 9:24 AM
Details	340B ID	Insert			ONLINE_REG	1/7/2013 9:24 AM
Details	Is Authorizing Official EHB Data	Insert				1/7/2013 9:24 AM
Dates	Last Date That 340B Drugs Purchased	Insert				1/7/2013 9:24 AM
Details	Medicare Provider Number	Insert			440025	1/7/2013 9:24 AM
Details	Entity Name	Insert			LAUGHLIN MEMORIAL HOSPITAL, INC.	1/7/2013 9:24 AM
Details	Program Code	Insert			RRC	1/7/2013 9:24 AM
Details	Entity Subname	Insert				1/7/2013 9:24 AM
Dates	Participating Approval Date	Insert				1/7/2013 9:24 AM
Details	State	Insert			Pending	1/7/2013 9:24 AM
Dates	Registration Date	Insert			1/7/2013 12:00:00 AM	1/7/2013 9:24 AM
Dates	Signed By Date	Insert			1/7/2013 12:00:00 AM	1/7/2013 9:24 AM
Dates	Start Date	Insert				1/7/2013 9:24 AM
Terminations	Termination Comments	Insert				1/7/2013 9:24 AM
Terminations	Termination Date	Insert				1/7/2013 9:24 AM
Terminations	Termination Effective Date	Insert				1/7/2013 9:24 AM
Terminations	Termination Reason	Insert				1/7/2013 9:24 AM