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LITTLE DRUG COMPANY, LLC
DSH010051 GREENE COUNTY HOSPITAL
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Covered Entity Details
Entity Name
GREENE COUNTY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010051
Entity Address
509 WILSON AVENUE
EUTAW, AL 35462
Medicare Provider Number
010051
Participating Start Date
10/1/2017
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
LITTLE DRUG COMPANY, LLC
Pharmacy Address
310 S MAIN ST
PO BOX 480999
LINDEN, AL 36748-1726
Pharmacy Comments
Contract Details
Approval Date
4/15/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Marcia Pugh, CEO
(205) 372-3388 Ext: 211
Contract Pharmacy Representative
Greene County Hospital
Marcia Pugh, CEO
(205) 372-3388 Ext: 211
Signed By Date
4/15/2020
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