340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AFFILIATED HEALTH SERVICES, INC.
DSH440151 Saint Thomas River Park Hospital, LLC d/b/a Ascension Saint Thomas River Park
Print
Covered Entity Details
Entity Name
Saint Thomas River Park Hospital, LLC d/b/a Ascension Saint Thomas River Park
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH440151
Entity Address
1559 SPARTA ROAD
MCMINNVILLE, TN 37110
Medicare Provider Number
440151
Participating Start Date
4/1/2017
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
AFFILIATED HEALTH SERVICES, INC.
Pharmacy Address
DBA ASCENSION RX 1303
30055 NORTHWESTERN HWY
STE 225
FARMINGTON HILLS, MI 48334
Pharmacy Comments
Contract Details
Approval Date
7/8/2021
Contract Begin Date
10/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/24/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lisa R. Davis, TN Ministry Market CFO Saint Thomas
(615) 284-6845
Contract Pharmacy Representative
Ascension Michigan Pharmacy
Deborah Sopo, Pharmacy Manager
(248) 865-3770
Signed By Date
7/8/2021
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