340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
Kroger Pharmacy #024-845
DSH440039 Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic
Print
Covered Entity Details
Entity Name
Vanderbilt University Medical Center d/b/a Vanderbilt University Hospital and Clinic
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH440039
Entity Address
1211 MEDICAL CENTER DRIVE
NASHVILLE, TN 37232
Medicare Provider Number
440039
Participating Start Date
7/1/2002
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
Kroger Pharmacy #024-845
Pharmacy Address
143 MCGAVOCK PIKE
Nashville, TN 37214
Pharmacy Comments
07/06/2012 changed city (was Donelson)
Contract Details
Approval Date
6/6/2012
Contract Begin Date
6/6/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/18/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Warren Beck, Chief Financial Officer
(615) 343-9908
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
5/24/2012
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