340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WELLSTAR PHARMACY NETWORK #3
DSH110143 COBB HOSPITAL, INC.
Print
Covered Entity Details
Entity Name
COBB HOSPITAL, INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH110143
Entity Address
3950 AUSTELL ROAD
AUSTELL, GA 30106
Medicare Provider Number
110143
Participating Start Date
10/1/2004
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
WELLSTAR PHARMACY NETWORK #3
Pharmacy Address
3950 AUSTELL RD STE MAIN
SUITE 8
AUSTELL, GA 30106
Pharmacy Comments
Contract Details
Approval Date
10/4/2017
Contract Begin Date
1/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DAROLD ETHERIDGE, CFO
(470) 732-5039
Contract Pharmacy Representative
WellStar Health System
Snehal Doshi, SVP Ancillary and Support Svcs
(470) 644-0322
Signed By Date
10/4/2017
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