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HEMOPHILIA PREFERRED CARE OF MEMPHIS
HM38103 UT-MEMPHIS DBA UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER
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Covered Entity Details
Entity Name
UT-MEMPHIS DBA UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER
Subdivision Name
UT Hematology
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM38103
Entity Address
6401 Poplar Ave
Suite 195
Memphis, TN 38119
Grant Number
H30MC24046-02-02
Participating Start Date
1/1/2016
Last Recertification Date
2/25/2021
Entity Termination Date
2/11/2022
Pharmacy Details
Pharmacy Name
HEMOPHILIA PREFERRED CARE OF MEMPHIS
Pharmacy Address
HPC SPECIALTY PHARMACY
6423 SHELBY VIEW DR
STE 104
MEMPHIS, TN 38134
Pharmacy Comments
Contract Details
Approval Date
7/15/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/11/2022
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Joseph Misleh, Executive Director, Business Development
(901) 866-8439
Contract Pharmacy Representative
Ron Cieutat, CEO
(251) 441-1990
Signed By Date
7/15/2017
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