340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH440002E JACKSON-MADISON COUNTY GENERAL HOSP (Terminated)
Print
Main Details
Name
JACKSON-MADISON COUNTY GENERAL HOSP
Subdivision Name
Skyline Endoscopy Clinic - gastrointestinal
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440002E
Medicare Provider Number
440002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
4/13/2022
Participating Start Date
7/1/2022
Participating Approval Date
5/24/2022
Last Recertification Date
9/8/2022
Termination Date
Termination Reason
10/1/2023
Site closure
Contacts
Authorizing Official
West Tennessee Healthcare
Jeff Blankenship, CFO
(731) 541-6739
Primary Contact
West Tn Healthcare
Sherry Osborne, Executive Director of Pharmacy
(731) 541-6229
Addresses
Street Address
27 Medical Center Drive
Jackson, TN 38301
Billing Address
Jackson-Madison County General Hospital
620 Skyline Drive
Jackson, TN 38301
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
1
to
1
of
1
Page:
of 1
Go
Page size:
Change
Participating from effective date: (10/1/2020) until terminated effective date: (1/1/2022), reinstatement effective date: (07/01/2022)
05/23/2022
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session