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BATTS DRUG CO
DSH110135 R. J. Taylor Memorial Hospital
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Covered Entity Details
Entity Name
R. J. Taylor Memorial Hospital
Subdivision Name
DBA Taylor Regional Hospital
Type
Disproportionate Share Hospital
340B ID
DSH110135
Entity Address
222 Perry Highway
Hawkinsville, GA 31036
Medicare Provider Number
110135
Participating Start Date
3/15/2022
Last Recertification Date
9/7/2022
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
BATTS DRUG CO
Pharmacy Address
115 COMMERCE ST
HAWKINSVILLE, GA 31036
Pharmacy Comments
Contract Details
Approval Date
4/10/2012
Contract Begin Date
4/10/2012
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/31/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Dan Maddock, CEO
(478) 783-0200
Contract Pharmacy Representative
Ben Cravey, Pharmacist
(478) 892-9021
Signed By Date
3/5/2012
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