340B Drug Pricing Program Database
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DSH440132C HENRY COUNTY MEDICAL CENTER (Terminated)
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Main Details
Name
HENRY COUNTY MEDICAL CENTER
Subdivision Name
Eagle Creek - Eagle Creek
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440132C
Medicare Provider Number
440132
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
10/7/2022
Participating Start Date
1/1/2023
Participating Approval Date
11/21/2022
Last Recertification Date
Termination Date
Termination Reason
10/1/2023
Business decision by the Covered Entity
Contacts
Authorizing Official
Henry County Medical Center
John Robert Tucker, CEO
(731) 644-8478
Primary Contact
Henry County Medical Center
Paula Carter Bell, Director of Pharmacy
(731) 644-8579
Addresses
Street Address
14201 US-79
Unit 4
Buchanan, TN 38222
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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