340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MOUNTAIN CITY PHARMACY
CAH441304-00 JOHNSON COUNTY COMMUNITY HOSPITAL
Print
Covered Entity Details
Entity Name
JOHNSON COUNTY COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH441304-00
Entity Address
1901 SOUTH SHADY STREET
MOUNTAIN CITY, TN 37683
Medicare Provider Number
441304
Participating Start Date
10/1/2018
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
MOUNTAIN CITY PHARMACY
Pharmacy Address
1641 S SHADY ST
MOUNTAIN CITY, TN 37683
Pharmacy Comments
Contract Details
Approval Date
7/31/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shane Hilton, EVP, Chief Financial Officer
(423) 302-3467
Contract Pharmacy Representative
Mountain City Pharmacy
Corey Furman, President
(423) 727-0038
Signed By Date
7/13/2018
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