340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ELY DRUGS INC. # 2
DSH180017 TJ SAMSON COMMUNITY HOSPITAL
Print
Covered Entity Details
Entity Name
TJ SAMSON COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180017
Entity Address
1301 NORTH RACE STREET
GLASGOW, KY 42141
Medicare Provider Number
180017
Participating Start Date
7/1/2005
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
ELY DRUGS INC. # 2
Pharmacy Address
415 HAPPY VALLEY RD
GLASGOW, KY 42141
Pharmacy Comments
Contract Details
Approval Date
4/2/2020
Contract Begin Date
5/5/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Neil Thornbury, CEO
(270) 651-4159
Contract Pharmacy Representative
Ely Drugs
Travis Hudnall, President
(270) 651-8359
Signed By Date
4/2/2020
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