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DURENS HEALTH MART
CH041370 PERRY COUNTY MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
PERRY COUNTY MEDICAL CENTER, INC.
Subdivision Name
PERRY COUNTY MEDICAL CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH041370
Entity Address
115 E BROOKLYN STREET
LINDEN, TN 37096
Grant Number
H80CS00346
Participating Start Date
4/1/2005
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
DURENS HEALTH MART
Pharmacy Address
119 S MILL ST
PO BOX 629
LINDEN, TN 37096-6457
Pharmacy Comments
Contract Details
Approval Date
5/23/2012
Contract Begin Date
5/23/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
PHILLIP TATUM, CEO
(931) 589-2104
Contract Pharmacy Representative
Jeff Duren, Owner
(931) 722-5466
Signed By Date
5/18/2012
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