340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CRMC OUTPATIENT PHARMACY
RRC440059-00 COOKEVILLE REGIONAL MEDICAL CENTER
Print
Covered Entity Details
Entity Name
COOKEVILLE REGIONAL MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC440059-00
Entity Address
142 WEST FIFTH STREET
COOKEVILLE, TN 38501
Medicare Provider Number
440059
Participating Start Date
4/1/2025
Last Recertification Date
Pharmacy Details
Pharmacy Name
CRMC OUTPATIENT PHARMACY
Pharmacy Address
1 MEDICAL CENTER BLVD
COOKEVILLE, TN 38501
Pharmacy Comments
Contract Details
Approval Date
4/2/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/14/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
PAUL Dudley KORTH, CEO
(931) 783-2000
Contract Pharmacy Representative
Leah Ingram, Director of Pharmacy
(931) 783-2598
Signed By Date
4/2/2014
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