340B Drug Pricing Program Database
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DSH440104GT Erlanger Health (Active)
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Main Details
Name
Erlanger Health
Subdivision Name
EMG Cardiology Cleveland - EMG Cardiology Cleveland
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440104GT
Medicare Provider Number
440104
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
4/10/2020
Participating Start Date
7/1/2020
Participating Approval Date
4/15/2020
Last Recertification Date
9/8/2024
Contacts
Authorizing Official
Erlanger Health
Misty Brackett, VP Revenue Cycle
(423) 778-9775
Primary Contact
Erlanger Health System
Ngoc T. Le, 340B Program Coordinator
(423) 778-8194
Addresses
Street Address
4312 Holiday Inn Express Way
Suite 203
Cleveland, TN 37312
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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