340B Drug Pricing Program Database
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DSH440104AB ERLANGER MEDICAL CENTER (Terminated)
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Main Details
Name
ERLANGER MEDICAL CENTER
Subdivision Name
EN - Nuclear Medicine
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440104AB
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
9/2/2020
Termination Date
Termination Reason
10/1/2021
Business decision by the Covered Entity
Contacts
Authorizing Official
Erlanger Health System
Christopher Scott Spady, Vice President, Revenue Cycle
(423) 778-4786
Primary Contact
Erlanger Health System
Ngoc T. Le, 340B Program Coordinator
(423) 778-8194
Addresses
Street Address
632 Morrison Springs Road
Chattanooga, TN 37415
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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