340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
BAINBRIDGE PHARMACY
DSH110194 DONALSONVILLE HOSPITAL
Print
Covered Entity Details
Entity Name
DONALSONVILLE HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH110194
Entity Address
102 HOSPITAL CIRCLE
DONALSONVILLE, GA 39845
Medicare Provider Number
110194
Participating Start Date
7/1/2013
Last Recertification Date
9/8/2016
Entity Termination Date
10/1/2016
Pharmacy Details
Pharmacy Name
BAINBRIDGE PHARMACY
Pharmacy Address
1420 E EVANS ST
BAINBRIDGE, GA 39819-4336
Pharmacy Comments
Contract Details
Approval Date
7/3/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2016
Contacts
Covered Entity Signing Official
Chuck Orrick, Administrator
(229) 524-5217 Ext: 213
Contract Pharmacy Representative
Bainbridge Pharmacy
Edward Franklin Reynolds, Owner & President
(229) 723-3441
Signed By Date
7/3/2013
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