340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WILLIAMSON PHARMACY
DSH180069 TUG VALLEY ARH REGIONAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
TUG VALLEY ARH REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180069
Entity Address
260 HOSPITAL DRIVE
SOUTH WILLIAMSON, KY 41503
Medicare Provider Number
180069
Participating Start Date
4/1/2005
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WILLIAMSON PHARMACY
Pharmacy Address
54 W 2ND AVE
WILLIAMSON, WV 25661
Pharmacy Comments
Contract Details
Approval Date
7/7/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Contract Pharmacy Representative
Williamson Pharmacy
Hershel Baker Jr., Owner
(304) 235-3784
Signed By Date
7/7/2020
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