340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CVS TN DISTRIBUTION, LLC
SCH110124-00 Wayne Memorial Hospital
Print
Covered Entity Details
Entity Name
Wayne Memorial Hospital
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH110124-00
Entity Address
865 South First Street
Jesup, GA 31545
Medicare Provider Number
110124
Participating Start Date
1/1/2012
Last Recertification Date
8/19/2019
Entity Termination Date
7/1/2020
Pharmacy Details
Pharmacy Name
CVS TN DISTRIBUTION, LLC
Pharmacy Address
10017 KINGSTON PIKE
KNOXVILLE, TN 37922
Pharmacy Comments
Contract Details
Approval Date
1/2/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/19/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Gregory A. Jones, CFO
(912) 530-3305
Contract Pharmacy Representative
CVS Rx Services, Inc
Jordan Birnbaum, 340B Vendor Manager
(401) 770-2241
Signed By Date
1/2/2015
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