340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
K & B TENNESSEE CORPORATION
DSH250141 BAPTIST MEMORIAL HOSPITAL- DESOTO
Print
Covered Entity Details
Entity Name
BAPTIST MEMORIAL HOSPITAL- DESOTO
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH250141
Entity Address
7601 SOUTHCREST PARKWAY
SOUTHAVEN, MS 38671-4739
Medicare Provider Number
250141
Participating Start Date
9/5/2008
Last Recertification Date
9/15/2019
Entity Termination Date
4/1/2020
Pharmacy Details
Pharmacy Name
K & B TENNESSEE CORPORATION
Pharmacy Address
RITE AID #7205
7570 WEST FARMINGTON AVE.
GERMANTOWN, TN 38138
Pharmacy Comments
Contract Details
Approval Date
4/15/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/28/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
James Huffman, CEO and Administrator
(662) 772-2118
Contract Pharmacy Representative
Rite Aid
Tammy Royer, Group Vice President, Managed Care
(717) 730-8217
Signed By Date
4/15/2014
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