340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH490002 RUSSELL COUNTY HOSPITAL (Active)
Print
Main Details
Name
RUSSELL COUNTY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH490002
Medicare Provider Number
490002
Additional Details
Current Program Status
Active
Registration Date
4/2/2020
Participating Start Date
4/22/2020
Participating Approval Date
4/7/2020
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Ballad Health
Shane Hilton, EVP, Chief Financial Officer
(423) 302-3467
Primary Contact
Ballad Health
Trish Tanner, VP, Chief Pharmacy Officer
(423) 302-3532
Addresses
Street Address
58 Carroll Street
LEBANON, VA 24266
Billing Address
Russell County Hospital
58 Carroll Street
Lebanon, VA 24266
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
3
of
3
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
3
of
3
Page:
of 1
Go
Page size:
Change
Correction: Participating start date7/1/2009; Terminated 4/1/2017; Reinstated 4/22/2020
04/23/2020
Participating start date7/1/2009; Terminated 4/1/2017; Reinstated 7/1/2020
04/07/2020
3/24/2010- DOC. RECD. TO CONFIRM ELIG. OWNERSHIP TYPE
10/29/2010
April 2025
April 2025
week
S
M
T
W
T
F
S
14
30
31
1
2
3
4
5
15
6
7
8
9
10
11
12
16
13
14
15
16
17
18
19
17
20
21
22
23
24
25
26
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session