340B Drug Pricing Program Database
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DSH440104AH ERLANGER MEDICAL CENTER (Terminated)
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Main Details
Name
ERLANGER MEDICAL CENTER
Subdivision Name
TCTCH Clinics
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440104AH
Medicare Provider Number
440104
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/29/2014
Participating Start Date
1/1/2015
Participating Approval Date
11/5/2014
Last Recertification Date
9/8/2020
Termination Date
Termination Reason
1/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Erlanger Health System
BRITTON J. TABOR, CFO
(423) 778-7729
Primary Contact
Erlanger Health System
Ngoc T. Le, 340B Program Coordinator
(423) 778-8194
Addresses
Street Address
910 Blackford Street
Chattanooga, TN 37403
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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April 2025
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