Registrations and Recertifications for Entities other than Hospitals

Enrollment and Re-Certification of Entities in the 340B Drug Pricing Program and Collection of Manufacturer Data to Verify 340B Drug Pricing Program Ceiling Price Calculations

OMB: 0915-0327

IC ID: 190347

Documents and Forms

Document Name Document Type
Form 2.1 Registrations and Recertifications for Entities other than Hospitals Form
2.1 340B Registration CHC and FQHCLA.pdf 340B Registration-Community Health Center.docx.pdf Form
2.2 340B Registration STD and TB.pdf 340B Registration-STD.TB.pdf Form
2.3 340B Registration-Covered Entities All Other Non-Hospita 340B Registration-Covered Entities All Other.docx.pdf Form
2.4 340B Recertfication STD and TB.pdf 340B Recertfication-STD.TB.pdf Form
2.5 340B Recertification CHC and FQHCLA.pdf 340B Recertification-Community Health Center and Look alike.pdf Form
2.6 340B Recertification Covered Entities All Other Non-Hosp 340B Recertification-Covered Entities All Other.pdf Form
340B Registration-Community Health Center Redline.pdf 340B Registration-Community Health Center Redline IC Document
340B Registration-Covered Entities All Other Redline.docx.pdf 340B Registration-Covered Entities All Other Redline.docx IC Document
340B Registration-STD.TB Redline.pdf 340B Registration-STD.TB Redline IC Document
340B Recertfication-STD Redline.pdf 340B Recertfication-STD Redline IC Document
340B Recertification-Community Health Center and Look alike Redline.pdf 340B Recertification-Community Health Center and Look alike Redline IC Document
340B Recertification-Covered Entities All Other redline.pdf 340B Recertification-Covered Entities All Other redline IC Document