340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
ARCHBOLD PINETREE PHARMACY
RRC110038-00 John D. Archbold Memorial Hospital, Inc.
Print
Covered Entity Details
Entity Name
John D. Archbold Memorial Hospital, Inc.
Subdivision Name
Type
Rural Referral Center
340B ID
RRC110038-00
Entity Address
Gordon Avenue at Mimosa Drive
Thomasville, GA 31792
Medicare Provider Number
110038
Participating Start Date
1/1/2014
Last Recertification Date
8/17/2015
Entity Termination Date
4/1/2016
Pharmacy Details
Pharmacy Name
ARCHBOLD PINETREE PHARMACY
Pharmacy Address
2705 E PINETREE BLVD STE F
THOMASVILLE, GA 31792-4875
Pharmacy Comments
Contract Details
Approval Date
1/3/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2016
Covered Entity Terminated
Contacts
Covered Entity Signing Official
CHARLES D. HIGHTOWER, CFO
(229) 228-2853
Contract Pharmacy Representative
John D. Archbold Memorial Hospital
Chris Newman, Vice President, Clinical and Support Services
(229) 228-2771
Signed By Date
1/3/2014
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