340B Drug Pricing Program Database
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DSH440104DB ERLANGER MEDICAL CENTER (Terminated)
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Main Details
Name
ERLANGER MEDICAL CENTER
Subdivision Name
Ortho Residency Program
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440104DB
Medicare Provider Number
440104
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/4/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/3/2016
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
979 East Third Street
Suite B200
Chattanooga, TN 37403
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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