340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
EAST HICKMAN PHARMACY
CH041370 PERRY COUNTY MEDICAL CENTER, INC.
Print
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
EAST HICKMAN PHARMACY
Pharmacy Address
7723 CLEARVIEW CHURCH LN
LYLES, TN 37098-1674
Pharmacy Comments
Contract Details
Approval Date
7/1/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
PHILLIP TATUM, CEO
(931) 589-2104
Contract Pharmacy Representative
John Kelsey, Owner
(931) 670-6035
Signed By Date
7/1/2013
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