340B Drug Pricing Program Database
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DSH440073A MAURY REGIONAL HOSPITAL (Active)
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Main Details
Name
MAURY REGIONAL HOSPITAL
Subdivision Name
IV Therapy/Infusion Center
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440073A
Medicare Provider Number
440073
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/13/2022
Participating Start Date
7/20/2022
Participating Approval Date
7/21/2022
Last Recertification Date
8/15/2024
Contacts
Authorizing Official
Maury Regional Health
Martin Chaney, Chief Executive Officer
(931) 380-4008
Primary Contact
Maury Regional Outpatient Pharmacy
Drew Keller, Pharmacy Manager
(931) 381-1111 Ext: 1134
Addresses
Street Address
808 S. James Campbell Blvd.
Columbia, TN 38401
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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Participating Start Date 10/1/2012, Termination Date 7/1/2013, Reinstatement 7/20/2022
07/20/2022
April 2025
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