Covered Entity Details

DSH180087R TAYLOR COUNTY HOSPITAL DISTRICT (Active) - information as of 5/14/2025 10:48:00 PM

Main Details

Name

TAYLOR COUNTY HOSPITAL DISTRICT

Subdivision Name

TRPC-Lebanon - Family Practice

Type

Disproportionate Share Hospital

Rural

Yes

340B ID

DSH180087R

Medicare Provider Number

180087

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

1/8/2025

Participating Start Date

4/1/2025

Participating Approval Date

1/31/2025

Last Recertification Date

Contacts

Authorizing Official

Taylor Regional Hospital
CATHERINE SETTLE, CLINICAL SERVICES ADMINISTRATOR
(270) 789-6178

Primary Contact

Taylor Regional Hospital
ERIC SPROWLES, DIRECTOR OF PHARMACY
(270) 465-3561

Addresses

Street Address

215 N. Depot St.
Lebanon, KY 40033

Billing Address
Same as Street Address

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
Yes

State	Medicaid Number	NPI Number
KY	01021039

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
No records to display.

Parent/Child

340B ID	Hierarchy	Entity Type	Name	Sub Name	Address	City	State	340B Status
DSH180087D	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TAYLOR REGIONAL HOSPITAL / MEDICAL ONCOLOGY	125 GREENBRIAR DRIVE	CAMPBELLSVILLE	KY	Active
DSH180087E	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TAYLOR REGIONAL INTERNAL MEDICINE ASSOCIATES - INTERNAL MEDICINE	95 KINGSWOOD DR.	CAMPBELLSVILLE	KY	Active
DSH180087F	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	Taylor Regional Primary Care - Primary Care	1911 CAMPBELLSVILLE RD	GREENSBURG	KY	Active
DSH180087G	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TAYLOR REGIONAL UROLOGY - UROLOGY	1698 OLD LEBANON RD.	CAMPBELLSVILLE	KY	Active
DSH180087H	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TAYLOR REGIONAL SURGICAL ASSOCIATES - GENERAL SURGERY	1698 OLD LEBANON RD.	CAMPBELLSVILLE	KY	Active
DSH180087J	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TAYLOR REGIONAL PULMONARY AND SLEEP - PULMONARY AND SLEEP MEDICINE	67 KINGSWOOD DR.	CAMPBELLSVILLE	KY	Active
DSH180087K	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TAYLOR REGIONAL NEUROLOGY - NEUROLOGY	1862 OLD LEBANON RD	CAMPBELLSVILLE	KY	Active
DSH180087L	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TAYLOR REGIONAL ORTHOPEDICS - ORTHOPEDICS	100 MEDICAL PARK DR.	CAMPBELLSVILLE	KY	Active
DSH180087M	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TAYLOR REGIONAL PHYSICIANS FOR WOMEN - OB/GYN	105 GREENBRIAR DR.	CAMPBELLSVILLE	KY	Active
DSH180087N	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TAYLOR REGIONAL ENT - EAR NOSE AND THROAT	105 GREENBRIAR DR	CAMPBELLSVILLE	KY	Active
DSH180087P	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	Taylor Regional Hospital Health Clinic - Family Practice	73 Kingswood Dr.	Campbellsville	KY	Active
DSH180087Q	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	Taylor Regional IM - Internal Medicine	111 Kingswood Dr.	Campbellsville	KY	Active
DSH180087R	Child	DSH	TAYLOR COUNTY HOSPITAL DISTRICT	TRPC-Lebanon - Family Practice	215 N. Depot St.	Lebanon	KY	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	State	Update		Approved	Active	4/1/2025 12:01 AM
Contacts	Signed By	Insert	New Registration		SETTLE, CATHERINE CLINICAL SERVICES ADMINISTRATOR Taylor Regional Hospital 2707896178	1/31/2025 9:37 AM
Details	340B ID	Update	New Registration		DSH180087R	1/31/2025 9:37 AM
Details	Entity Name	Update	New Registration	TAYLOR REGIONAL HOSPITAL	TAYLOR COUNTY HOSPITAL DISTRICT	1/31/2025 9:37 AM
Details	Entity Subname	Update	New Registration	TRPC-Lebanon	TRPC-Lebanon - Family Practice	1/31/2025 9:37 AM
Dates	Participating Approval Date	Update	New Registration		1/31/2025 9:37:50 AM	1/31/2025 9:37 AM
Details	State	Update	New Registration	Pending	Approved	1/31/2025 9:37 AM
Dates	Signed By Date	Update	New Registration		1/8/2025 12:47:30 PM	1/31/2025 9:37 AM
Dates	Start Date	Update	New Registration		4/1/2025 12:00:00 AM	1/31/2025 9:37 AM
Addresses	Main Address	Insert	New Registration		215 N. Depot St. Lebanon, KY 40033	1/8/2025 11:01 AM
Medicaid Billing	Medicaid: Is Primary	Insert	New Registration		False	1/8/2025 11:01 AM
Medicaid Billing	Medicaid: Number	Insert	New Registration		01021039	1/8/2025 11:01 AM
Medicaid Billing	Medicaid: State	Insert	New Registration		KY	1/8/2025 11:01 AM
Contacts	Primary Contact	Insert	New Registration		SPROWLES, ERIC DIRECTOR OF PHARMACY Taylor Regional Hospital 2704653561	1/8/2025 11:01 AM
Contacts	Authorizing Official	Insert	New Registration		SETTLE, CATHERINE CLINICAL SERVICES ADMINISTRATOR Taylor Regional Hospital 2707896178	1/8/2025 11:01 AM
Details	Assistance Received From Date	Insert	New Registration			1/8/2025 11:01 AM
Details	Assistance Received To Date	Insert	New Registration			1/8/2025 11:01 AM
Details	Last Recertification Date	Insert	New Registration			1/8/2025 11:01 AM
Details	Grant Number	Insert	New Registration			1/8/2025 11:01 AM
Details	340B ID	Insert	New Registration			1/8/2025 11:01 AM
Details	Is Authorizing Official EHB Data	Insert	New Registration			1/8/2025 11:01 AM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			1/8/2025 11:01 AM
Details	Medicare Provider Number	Insert	New Registration		180087	1/8/2025 11:01 AM
Details	Entity Name	Insert	New Registration		TAYLOR REGIONAL HOSPITAL	1/8/2025 11:01 AM
Details	NOFO Number	Insert	New Registration			1/8/2025 11:01 AM
Details	Program Code	Insert	New Registration		DSH	1/8/2025 11:01 AM
Details	Entity Subname	Insert	New Registration		TRPC-Lebanon	1/8/2025 11:01 AM
Dates	Participating Approval Date	Insert	New Registration			1/8/2025 11:01 AM
Details	State	Insert	New Registration		Pending	1/8/2025 11:01 AM
Dates	Registration Date	Insert	New Registration		1/8/2025 11:01:42 AM	1/8/2025 11:01 AM
Dates	Signed By Date	Insert	New Registration			1/8/2025 11:01 AM
Dates	Start Date	Insert	New Registration			1/8/2025 11:01 AM
Terminations	Termination Comments	Insert	New Registration			1/8/2025 11:01 AM
Terminations	Termination Date	Insert	New Registration			1/8/2025 11:01 AM
Terminations	Termination Effective Date	Insert	New Registration			1/8/2025 11:01 AM
Terminations	Termination Reason	Insert	New Registration			1/8/2025 11:01 AM