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ERLANGER PHARMACIES INC
CH041260 ERLANGER HEALTH SYSTEM SOUTHSIDE/DODSON AVE CHC
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Covered Entity Details
Entity Name
ERLANGER HEALTH SYSTEM SOUTHSIDE/DODSON AVE CHC
Subdivision Name
SOUTHSIDE COMMUNITY HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH041260
Entity Address
3800 Tennessee Ave.
Suite 124
CHATTANOOGA, TN 37409
Grant Number
H80CS00091
Participating Start Date
12/1/1992
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
ERLANGER PHARMACIES INC
Pharmacy Address
DBA ERLANGER PHARMACY
1751 GUNBARREL RD SUITE G-5
CHATTANOOGA, TN 37421
Pharmacy Comments
11/15/2012 name update (was ERLANGER PHARMACIES, INC. DBA: MOORE AND KING PHARMACY)6/24/2010 - ADDRESS CHANGED FROM 1651 GUNBARREL ROAD, SUITE 101A
Contract Details
Approval Date
4/16/2013
Contract Begin Date
7/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2017
Ownership change
Contacts
Covered Entity Signing Official
Joe Winick, Sr. VP of Planning Business Development
(423) 778-8088
Contract Pharmacy Representative
Donna Bourdon, President
(423) 386-1017
Signed By Date
4/16/2013
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