340B Drug Pricing Program Database


CHC26598-06 Maury Regional Hospital (Active) - information as of 5/9/2025 12:08:13 AM

Main Details
Maury Regional Hospital
Lewisburg Family Practice
HRSA-Funded Health Center
BPS-H80-027712
CHC26598-06
H80CS26598


Additional Details
Active
2/11/2021
4/1/2021
2/12/2021
2/12/2025

Contacts

Maury Regional Health
Martin Chaney, Chief Executive Officer
(931) 380-4008

Maury Regional Outpatient Pharmacy
Drew Keller, Pharmacy Manager
(931) 381-1111 Ext: 1134

Addresses

1090 N. Ellington Pkwy STE 102 B
Lewisburg, TN 37091-2227

Same as Street Address


  • Comments
  • Medicaid Billing
  • Shipping Addresses
  • Contract Pharmacies
  • Grantee Sites
  • Grantee Sites Contract Pharmacies
  • History
Comments
CommentLast Updated On 
No records to display.
Medicaid Billing

Yes
StateMedicaid NumberNPI Number
TNQ0217791578921763
Shipping Addresses

Same as Street Address
Contract Pharmacies
Contract DetailPharmacy NameAddressAddress Cont.CityStateZip CodeApproval DateBegin DateCarve-In Effective DateTermination DateLast Updated On
Contract DetailCVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005601/16/202404/01/2024  04/01/2024
Contract DetailTENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06413 1300 TROTWOOD AVENUE
COLUMBIATN3840101/16/202404/01/2024  04/01/2024
Contract DetailTENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06421 814 NASHVILLE HIGHWAY
COLUMBIATN3840101/16/202404/01/2024  04/01/2024
Contract DetailTENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06400 825 N. MAIN ST.
SHELBYVILLETN3716001/16/202404/01/2024  04/01/2024
Grantee Sites
340B ID 340B StatusSiteIdNameSub NameAddressAddress Cont.CityState
CHC26598-00ActiveBPS-H80-013313Maury Regional HospitalLewis Health Center617 W Main St HohenwaldTN
CHC26598-01ActiveBPS-H80-022144MAURY REGIONAL HOSPITALPrimeCare854 W. James M Campbell Blvd. COLUMBIATN
CHC26598-02ActiveBPS-H80-017676MAURY REGIONAL HOSPITALLewisburg Pediatrics1090 N. Ellington Pkwy, STE 201 LewisburgTN
CHC26598-03ActiveBPS-H80-017517MAURY REGIONAL HOSPITALLewisburg Family1090 N. Ellington Pkwy, STE 102 LewisburgTN
CHC26598-04ActiveBPS-H80-038432Maury Regional HospitalWaynesboro Primary Care321 Dexter L Woods Memorial Blvd WaynesboroTN
CHC26598-05TerminatedBPS-H80-027711Maury Regional HospitalPrimeCare Suite 403854 W James M Campbell Blvd Ste 403 ColumbiaTN
CHC26598-06ActiveBPS-H80-027712Maury Regional HospitalLewisburg Family Practice1090 N. Ellington Pkwy STE 102 B LewisburgTN
CHC26598-07TerminatedBPS-H80-035994MAURY REGIONAL HOSPITALMRMG Primary Care (Collinwood)902 Highway 13 S CollinwoodTN
Grantee Sites Contract Pharmacies
340B IDPharmacy NameAddressAddress Cont.CityStateZip CodeBegin DateCarve-In Effective DateTermination Date
CHC26598-00ACCREDO HEALTH GROUP INC3000 ERICSSON DRIVE, SUITE 100
WARRENDALEPA15086-750210/01/2021  
CHC26598-00ACCREDO HEALTH GROUP INC1620 CENTURY CENTER PKWY # 109
MEMPHISTN38134-884910/01/2021  
CHC26598-00ACCREDO HEALTH GROUP INC2040 W RIO SALADO PKWY STE 101B
TEMPEAZ85281-201010/01/2021  
CHC26598-00ACCREDO HEALTH GROUP, INC.2825 W PERIMETER RD STE 112
INDIANAPOLISIN4624110/01/2021 09/01/2023
CHC26598-00ACCREDO HEALTH GROUP, INC.2 BOULDEN CIR STE 1
NEW CASTLEDE19720-349210/01/2021  
CHC26598-00ACCREDO HEALTH GROUP, INC.6272 LEE VISTA BLVD STE 100
ORLANDOFL3282210/01/2021  
CHC26598-00ALABAMA CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04925 1002 COX CREEK PKWY.
FLORENCEAL3563307/01/2025  
CHC26598-00AVELLA OF DEER VALLEY23620 N 20TH DR #12
PHOENIXAZ85085-062101/01/2019 06/23/2022
CHC26598-00AVELLA OF DEER VALLEY, INC. #38DBA AVELLA SPECIALTY PHARMACY 24416 N. 19TH AVE
PHOENIXAZ8508501/01/2019  
CHC26598-00AVELLA OF ST LOUIS450 N NEW BALLAS RD STE 256
SAINT LOUISMO63141-683601/01/2019 06/23/2022
CHC26598-00BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 4740 VICTORY LN STE C
INDIANAPOLISIN4620307/01/2024  
CHC26598-00BIOPLUS SPECIALTY PHARMACY SERVICES, LLC376 NORTHLAKE BLVD
ALTAMONTE SPRINGSFL32701-526107/01/2024  
CHC26598-00BIOPLUS SPECIALTY PHARMACY SERVICES, LLCBIOPLUS SPECIALTY PHARMACY SERVICES, LLC 145 S 79TH ST STE 70
CHANDLERAZ8522607/01/2024  
CHC26598-00BIOPLUS SPECIALTY PHARMACY SERVICES, LLC13925 YALE AVE STE 145
IRVINECA92620-267007/01/2024  
CHC26598-00BIOPLUS SPECIALTY PHARMACY SERVICES, LLC4900 PROSPECTUS DR STE 300
DURHAMNC2771307/01/2024  
CHC26598-00CAREMARK FLORIDA SPECIALTY PHARMACY LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7930 WOODLAND CENTER BLVD STE 500
TAMPAFL3361401/01/2024  
CHC26598-00CAREMARK ILLINOIS SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 800 BIERMANN CT STE B
MOUNT PROSPECTIL6005601/01/2024  
CHC26598-00CAREMARK KANSAS SPECIALTY PHARMACYCVS/SPECIALTY OR CARELONRX SPECIALTY PHA 11162 RENNER BLVD
LENEXAKS6621901/01/2024  
CHC26598-00CAREMARK MASSACHUSETTS SPECIALTY PHARMACDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 25 BIRCH STREET, BLDG B, SUITE 100
MILFORDMA0175701/01/2024  
CHC26598-00CAREMARK MICHIGAN SPECIALTY PHARMACY, LLDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1307 ALLEN DR STE H
TROYMI4808301/01/2024  
CHC26598-00CAREMARK NEW JERSEY SPECIALTY PHCY, LLCDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 180 PASSAIC AVE UNIT B-5
FAIRFIELDNJ0700401/01/2024  
CHC26598-00CAREMARK NORTH CAROLINA SPECIALTY PHARMADBA CVS/SPECIALTY OR CARELONRX SPECIALTY 10700 WORLD TRADE BLVD STE 110
RALEIGHNC2761701/01/2024  
CHC26598-00CAREMARK TENNESSEE SPECIALTY PHARMACY, LDBA CVS/SPECIALTY OR CARELONRX SPECIALTY 8370 WOLF LAKE DR
STE 107 		BARTLETTTN3813301/01/2024  
CHC26598-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 1127 BRYN MAWR AVE
SUITE A 		REDLANDSCA9237401/01/2024  
CHC26598-00CAREMARK, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 7251 S. EASTERN AVE.
LAS VEGASNV8911901/01/2024  
CHC26598-00CVS CAREMARKDBA CVS/CAREMARK OR CF# 11506 1 GREAT VALLEY BOULEVARD
WILKES BARREPA1870610/01/2022  
CHC26598-00CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005610/01/2022  
CHC26598-03CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005604/01/2024  
CHC26598-04CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005604/01/2024  
CHC26598-06CVS CAREMARK ADVANCED TECHNOLOGY PHARMACDBA CVS/CAREMARK 48067 1780 WALL ST
MT PROSPECTIL6005604/01/2024  
CHC26598-00CVS/SPECIALTY OR CARELONRX SPECIALTY PHACAREMARK, LLC 1001 SPINKS ROAD, STE 280
FLOWER MOUNDTX7502801/01/2024  
CHC26598-00DOGWOOD PHARMACY LLCD/B/A MEDSCRIPTS MEDICAL PHARMACY 1325 MILLER RD
STE K 		GREENVILLESC29607-654107/01/2024  
CHC26598-00DUREN APOTHECARY110 KITTRELL ST
HOHENWALDTN38462-136307/01/2018  
CHC26598-00DUREN CLINICAL SERVICES LLCDBA DUREN PHARMACY 215 DEXTER L WOODS MEMORIAL BLVD
PO BOX 736 		WAYNESBOROTN3848507/01/2018  
CHC26598-00ESI MAIL PHARMACY SERVICEDBA EXPRESS SCRIPTS 7909 S HARDY DR STE 106
TEMPEAZ85284-111210/01/2021  
CHC26598-00EXPRESS RX OF LEWISBURGSCPG TENNESSEE LLC 521 W COMMERCE ST
LEWISBURGTN37091-321907/01/2025  
CHC26598-00EXPRESS SCRIPTSESI MAIL PHARMACY SERVICE INC 4600 N HANLEY RD
SAINT LOUISMO6313410/01/2021  
CHC26598-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 2040 ROUTE 130 NORTH
BURLINGTONNJ0801610/01/2021  
CHC26598-00EXPRESS SCRIPTS PHARMACY, INC.DBA EXPRESS SCRIPTS 4750 E. 450 S.
WHITESTOWNIN4607510/01/2021  
CHC26598-00H & S PHARMACY #2, INCH & S PHARMACY #1 521 WEST COMMERCE STREET
LEWISBURGTN3709107/01/2017 06/30/2020
CHC26598-00JONES HOMETOWN PHARMACY121 W MAIN ST
HOHENWALDTN38462-140407/01/2015 03/02/2017
CHC26598-00KENTUCKY CENTRAL FILL FACILITY, L-0105594 SHEPHERDSVILLE ROAD
LOUISVILLEKY40228-101212/01/2020 10/09/2022
CHC26598-00Kroger PharmacyJeffersonville Central Fill Facility 301 Logistics Ave
Suite 200 		JeffersonvilleIN4713001/01/2023  
CHC26598-00KROGER PHARMACY #5071202 S. JAMES CAMPBELL BLVD
COLUMBIATN3840112/01/2020  
CHC26598-00KROGER PHARMACY L - 5944900 PORT ROYAL ROAD
SPRINGHILLTN3717412/01/2020  
CHC26598-00KROGER PHARMACY L-534301 SOUTH ELLINGTON PARKWAY
LEWISBURGTN3709112/01/2020  
CHC26598-00KROGER PHARMACY L-538845 NASHVILLE HWY
COLUMBIATN3840112/01/2020  
CHC26598-00KROGER PHARMACY L-5884726 TRADERS WAY
THOMPSONS STATIONTN3717912/01/2020  
CHC26598-00KROGER PHARMACY L-8681700 NORTH LOCUST ST
LAWRENCEBURGTN3846412/01/2020  
CHC26598-00MAURY REGIONAL HOSPITAL PHARMACYMRH-DBA MAURY REGIONAL MEDICAL CENTER 1224 TROTWOOD AVE
COLUMBIATN38401-480204/01/2015  
CHC26598-00ONCOMED THE ONCOLOGY PHARMACY OF BUFFALOD/B/A ONCO360 140 JOHN JAMES AUDUBON PKWY STE 101
AMHERSTNY1422807/01/2016 03/02/2017
CHC26598-00OPTUM FRONTIER THERAPIES II, LLC6425 SANTA MARGARITA ST UNIT 110
LAS VEGASNV89118-191301/01/2020  
CHC26598-00OPTUM PHARMACY 702, LLC1050 PATROL RD
JEFFERSONVILLEIN4713001/01/2020  
CHC26598-00OPTUM PHARMACY 705, LLC1893 GENERAL GEORGE PATTON DR STE 106
FRANKLINTN37067-265501/01/2020  
CHC26598-00OPTUM PHARMACY 801, INC.24416 N 19TH AVE STE. 100
PHOENIXAZ8508507/16/2020  
CHC26598-00PROCARE PHARMACY DIRECT, L.L.C.DBA CVS/SPECIALTY OR CARELONRX SPECIALTY 105 MALL BOULEVARD
MONROEVILLEPA1514601/01/2024  
CHC26598-00PROCARE PHARMACY, L.L.C.DBA CVS/PHARMACY #2923 3250 HARDEN ST. EXT. SUITE #300
COLUMBIASC2920301/01/2024  
CHC26598-00PROCARE PHARMACY, L.L.C.DBA: CVS/PHARMACY #2909 1521 4TH AVE., SOUTH
BIRMINGHAMAL3523301/01/2024  
CHC26598-00RAINA RX LLCDBA ROUTE 300 PHARMACY 1208 ROUTE 300
SUITE 103 		NEWBURGHNY1255007/01/2024  
CHC26598-00RIVER MEDICAL PHARMACY LLC4752 RESEARCH DR
SAN ANTONIOTX78240-500207/01/2024  
CHC26598-00SANTA BARBARA SPECIALTY PHARMACY LLC4690 CARPINTERIA AVE STE B
CARPINTERIACA9301307/01/2024  
CHC26598-00SINA DRUG LLCDBA ONCO360 1985 MARCUS AVE STE 120
NEW HYDE PARKNY1104207/01/2016 03/02/2017
CHC26598-00SINA DRUG LLCD/B/A ONCO 360 13410 EASTPOINT CENTRE DR
STE 101 		LOUISVILLEKY4022307/01/2016 03/02/2017
CHC26598-00TENNESSEE CVS PHARMACY, L.L.C.CVS PHARMACY # 17426 1033 CROSSINGS BLVD
SPRING HILLTN3717412/01/2020  
CHC26598-00TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06421 814 NASHVILLE HIGHWAY
COLUMBIATN3840112/01/2020  
CHC26598-00TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06413 1300 TROTWOOD AVENUE
COLUMBIATN3840112/01/2020  
CHC26598-00TENNESSEE CVS PHARMACY, L.L.C.DBA CVS/PHARMACY # 10072 855 WAYNE RD.
SAVANNAHTN3837210/01/2022  
CHC26598-00TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 04365 709 W COLLEGE ST
PULASKITN3847810/01/2022  
CHC26598-00TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 386 4805 COLUMBIA PIKE
THOMPSON STATIONTN3717910/01/2022  
CHC26598-00TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06395 246 EAST GAINES STREET
LAWRENCEBURGTN3846410/01/2022  
CHC26598-00TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06400 825 N. MAIN ST.
SHELBYVILLETN3716010/01/2022  
CHC26598-03TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06400 825 N. MAIN ST.
SHELBYVILLETN3716004/01/2024  
CHC26598-01TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06413 1300 TROTWOOD AVENUE
COLUMBIATN3840104/01/2024  
CHC26598-06TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06413 1300 TROTWOOD AVENUE
COLUMBIATN3840104/01/2024  
CHC26598-06TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06421 814 NASHVILLE HIGHWAY
COLUMBIATN3840104/01/2024  
CHC26598-04TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06395 246 EAST GAINES STREET
LAWRENCEBURGTN3846404/01/2024  
CHC26598-03TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06421 814 NASHVILLE HIGHWAY
COLUMBIATN3840104/01/2024  
CHC26598-06TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06400 825 N. MAIN ST.
SHELBYVILLETN3716004/01/2024  
CHC26598-03TENNESSEE CVS PHARMACY, L.L.C.DBA: CVS/PHARMACY # 06413 1300 TROTWOOD AVENUE
COLUMBIATN3840104/01/2024  
CHC26598-00WAL-MART PHARMACY #10-1115612 E MAIN STREET
HOHENWALDTN3846201/01/2019  
CHC26598-00WAL-MART PHARMACY 10-01922200 BROOKMEADE DRIVE
COLUMBIATN3840101/01/2019  
CHC26598-00WAL-MART PHARMACY 10-07371334 NO. ELLINGTON PARKWAY
LEWISBURGTN3709101/01/2019  
CHC26598-00WALGREEN CO.DBA: WALGREENS # 09266 620 W COLLEGE ST
PULASKITN38478-361301/01/2019  
CHC26598-00WALGREEN CO.DBA: WALGREENS # 09510 758 ELLINGTON PKWY
LEWISBURGTN3709101/01/2019  
CHC26598-00WALGREEN CO.DBA: WALGREENS # 01989 4932 MAIN STREET
SPRING HILLTN37174-826201/01/2019  
CHC26598-00WALGREEN CO.DBA: WALGREENS # 09265 805 NASHVILLE HWY
COLUMBIATN38401-243101/01/2019  
CHC26598-00WALGREEN CO.DBA: WALGREENS # 09444 312 E GAINES STREET
LAWRENCEBURGTN38464-353201/01/2019  
CHC26598-00WALGREEN CO.DBA: WALGREENS #12273 4870 PORT ROYAL RD.
SPRING HILLTN3717401/01/2019  
CHC26598-00WALGREEN CO.DBA WALGREENS SPECIALTY PHARMACY #21215 309C 22ND AVE N
NASHVILLETN3720301/01/2019  
CHC26598-00WALGREEN CO.DBA: WALGREENS # 07659 1202 S JAMES CAMPBELL BLVD
COLUMBIATN3840101/01/2019  
CHC26598-00WALGREEN CO.WALGREENS #17830 801 N MAIN ST
MOUNT PLEASANTTN38474-101710/01/2022  
CHC26598-00WALGREEN CO.WALGREENS #18040 650 HIGHWAY 100
CENTERVILLETN37033-121410/01/2022  
CHC26598-00Walgreens #21389Walgreens Central Fill #21389 3299 Tchulatech Dr
Suite 101 		MemphisTN3811807/01/2022  
CHC26598-00WALMART PHARMACY 10-51692252 NORTH 8TH STREET
SUITE A 		ROGERSAR7275607/01/2023  
CHC26598-00Walmart Pharmacy 10-76112501 Perry Rd
PlainfieldIN4616801/01/2024  
History
SectionFieldActionActivityValue BeforeValue AfterTimestamp 
DetailsLast Recertification DateUpdateRecertification2/21/2024 11:41:02 AM2/12/2025 7:53:08 AM2/12/2025 7:53 AM
DetailsLast Recertification DateUpdateRecertification2/25/2023 4:54:51 PM2/21/2024 11:41:02 AM2/21/2024 11:41 AM
ContactsPrimary ContactUpdateChange RequestBinkley, Jeff Administrative Director, Pharmacy Maury Regional Health 9315404336Keller, Drew Pharmacy Manager Maury Regional Outpatient Pharmacy 9313811111-113411/8/2023 5:56 PM
ContactsAuthorizing OfficialUpdateProfile Change RequestChaney, Martin Chief Medical Officer Maury Regional Health 9314907080Chaney, Martin Chief Executive Officer Maury Regional Health 931380400811/1/2023 6:48 AM
ContactsAuthorizing OfficialUpdateChange RequestLumpkins, Deborah Sr. VP/CNO Maury Regional Medical Center 9314907118Chaney, Martin Chief Medical Officer Maury Regional Health 93149070807/19/2023 9:53 AM
DetailsLast Recertification DateUpdateRecertification2/28/2022 6:16:33 PM2/25/2023 4:54:51 PM2/25/2023 4:54 PM
DetailsLast Recertification DateUpdateRecertification 2/28/2022 6:16:33 PM2/28/2022 6:16 PM
DetailsStateUpdate ApprovedActive4/1/2021 12:01 AM
ContactsSigned ByInsertNew Registration Lumpkins, Deborah Sr. VP/CNO Maury Regional Medical Center 93149071182/12/2021 8:00 AM
Details340B IDUpdateNew Registration CHC26598-062/12/2021 8:00 AM
DatesParticipating Approval DateUpdateNew Registration 2/12/2021 8:00:35 AM2/12/2021 8:00 AM
DetailsStateUpdateNew RegistrationPendingApproved2/12/2021 8:00 AM
DatesSigned By DateUpdateNew Registration 2/11/2021 2:54:33 PM2/12/2021 8:00 AM
DatesStart DateUpdateNew Registration 4/1/2021 12:00:00 AM2/12/2021 8:00 AM
AddressesMain AddressInsertNew Registration  1090 N. Ellington Pkwy STE 102 B Lewisburg, TN 37091-22272/11/2021 11:20 AM
Medicaid BillingMedicaid: Is PrimaryInsertNew Registration False2/11/2021 11:20 AM
Medicaid BillingMedicaid: NumberInsertNew Registration Q0217792/11/2021 11:20 AM
Medicaid BillingMedicaid: StateInsertNew Registration TN2/11/2021 11:20 AM
Medicaid BillingNPI: NumberInsertNew Registration 15789217632/11/2021 11:20 AM
Medicaid BillingNPI: StateInsertNew Registration TN2/11/2021 11:20 AM
ContactsPrimary ContactInsertNew Registration Binkley, Jeff Administrative Director, Pharmacy Maury Regional Health 93154043362/11/2021 11:20 AM
ContactsAuthorizing OfficialInsertNew Registration Lumpkins, Deborah Sr. VP/CNO Maury Regional Medical Center 93149071182/11/2021 11:20 AM
DetailsAssistance Received From DateInsertNew Registration  2/11/2021 11:20 AM
DetailsAssistance Received To DateInsertNew Registration  2/11/2021 11:20 AM
DetailsLast Recertification DateInsertNew Registration  2/11/2021 11:20 AM
DetailsGrant NumberInsertNew Registration H80CS265982/11/2021 11:20 AM
Details340B IDInsertNew Registration  2/11/2021 11:20 AM
DetailsIs Authorizing Official EHB DataInsertNew Registration  2/11/2021 11:20 AM
DatesLast Date That 340B Drugs PurchasedInsertNew Registration  2/11/2021 11:20 AM
DetailsMedicare Provider NumberInsertNew Registration  2/11/2021 11:20 AM
DetailsEntity NameInsertNew Registration Maury Regional Hospital2/11/2021 11:20 AM
DetailsNOFO NumberInsertNew Registration  2/11/2021 11:20 AM
DetailsProgram CodeInsertNew Registration CH2/11/2021 11:20 AM
DetailsEntity SubnameInsertNew Registration Lewisburg Family Practice2/11/2021 11:20 AM
DatesParticipating Approval DateInsertNew Registration  2/11/2021 11:20 AM
DetailsStateInsertNew Registration Pending2/11/2021 11:20 AM
DatesRegistration DateInsertNew Registration 2/11/2021 11:20:39 AM2/11/2021 11:20 AM
DatesSigned By DateInsertNew Registration  2/11/2021 11:20 AM
DatesStart DateInsertNew Registration  2/11/2021 11:20 AM
TerminationsTermination CommentsInsertNew Registration  2/11/2021 11:20 AM
TerminationsTermination DateInsertNew Registration  2/11/2021 11:20 AM
TerminationsTermination Effective DateInsertNew Registration  2/11/2021 11:20 AM
TerminationsTermination ReasonInsertNew Registration  2/11/2021 11:20 AM