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ERLANGER PHARMACIES
DSH440104 Erlanger Health
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Covered Entity Details
Entity Name
Erlanger Health
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH440104
Entity Address
975 East Third Street
CHATTANOOGA, TN 37403
Medicare Provider Number
440104
Participating Start Date
12/1/1992
Last Recertification Date
9/11/2024
Pharmacy Details
Pharmacy Name
ERLANGER PHARMACIES
Pharmacy Address
DBA ERLANGER PHARMACY
979 EAST THIRD ST. SUITE 120
CHATTANOOGA, TN 37403
Pharmacy Comments
Contract Details
Approval Date
3/1/2009
Contract Begin Date
3/1/2009
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2017
Ownership change
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
2/20/2009
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