340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
DSH440002J JACKSON-MADISON COUNTY GENERAL HOSP (Active)
Print
Main Details
Name
JACKSON-MADISON COUNTY GENERAL HOSP
Subdivision Name
WEST TENNESSEE HEALTHCARE NORTH - Imaging
Type
Disproportionate Share Hospital
Rural
Yes
340B ID
DSH440002J
Medicare Provider Number
440002
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
1/13/2023
Participating Start Date
4/1/2023
Participating Approval Date
2/2/2023
Last Recertification Date
8/29/2024
Contacts
Authorizing Official
West Tennessee Healthcare
Jeff Blankenship, CFO
(731) 541-6739
Primary Contact
West Tennessee Healthcare
Dan Wichlan, Director of Pharmacy
(731) 541-5918
Addresses
Street Address
367 HOSPITAL BLVD
JACKSON, TN 38305-2080
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
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