340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
JACK'S DISCOUNT PHARMACY
DSH010058 BIBB MEDICAL CENTER
Print
Covered Entity Details
Entity Name
BIBB MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH010058
Entity Address
208 PIERSON AVENUE
CENTREVILLE, AL 35042
Medicare Provider Number
010058
Participating Start Date
7/1/2017
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
JACK'S DISCOUNT PHARMACY
Pharmacy Address
JACK'S DISCOUNT PHARMACY
23010 HIGHWAY 5
PO BOX 680
WEST BLOCTON, AL 35184-3522
Pharmacy Comments
Contract Details
Approval Date
4/12/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/31/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Joseph Marchant, CEO
(205) 926-3361
Contract Pharmacy Representative
Bibb Medical Center Pharmacy
Jennifer Guthrie, Pharmacy Director
(205) 926-3277
Signed By Date
4/12/2021
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