340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
TENNESSEE CVS PHARMACY, L.L.C.
DSH440109 HARDIN COUNTY GENERAL HOSPITAL
Print
Covered Entity Details
Entity Name
HARDIN COUNTY GENERAL HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH440109
Entity Address
935 WAYNE ROAD
SAVANNAH, TN 38372
Medicare Provider Number
440109
Participating Start Date
4/1/2006
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
TENNESSEE CVS PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY # 10072
855 WAYNE RD.
SAVANNAH, TN 38372
Pharmacy Comments
Contract Details
Approval Date
7/11/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/13/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mike Harbor, CFO
(731) 926-8090
Contract Pharmacy Representative
CVS Caremark
Anthony Gratto, 340B Vendor Manager
(401) 770-7298
Signed By Date
7/11/2013
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