Covered Entity Details

CAH181323-09 Ohio County Hospital (Active) - information as of 4/25/2025 6:29:35 PM

Main Details

Name

Ohio County Hospital

Subdivision Name

Ohio County Hospital Corporation - Ohio County Healthcare Behavioral Health

Type

Critical Access Hospital

Rural

Yes

340B ID

CAH181323-09

Medicare Provider Number

181323

Outpatient Facility Provider Number

Additional Details

Current Program Status

Active

Registration Date

7/11/2022

Participating Start Date

10/1/2022

Participating Approval Date

7/29/2022

Last Recertification Date

8/19/2024

Contacts

Authorizing Official

OCH
Stuart Randall Hibbs, CFO
(270) 298-5288

Primary Contact

Ohio County Hospital
Barry Anthony Ward, Pharmacy Director
(270) 298-5177

Addresses

Street Address

1621 N. Main Street
Beaver Dam, KY 42320

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?
No

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
CAH181323-01	Child	CAH	Ohio County Hospital	Ohio County Specialty Care- Riccio Clinic	112 McMurtry Avenue	Hartford	KY	Active
CAH181323-02	Child	CAH	Ohio County Hospital	Ohio County Family Care- Beaver Dam Clinic	1520 North Main Street	Beaver Dam	KY	Terminated
CAH181323-04	Child	CAH	Ohio County Hospital	Ohio County Family Care	20 McMurtry Avenue	Hartford	KY	Active
CAH181323-05	Child	CAH	Ohio County Hospital	Ohio County Specialty Care	1215 Old Main Street	Hartford	KY	Active
CAH181323-06	Child	CAH	Ohio County Hospital	Ohio County Family Care-Beaver Dam	1313 North Main Street	Beaver Dam	KY	Active
CAH181323-07	Child	CAH	Ohio County Hospital	FORDSVILLE AREA MEDICAL CLINIC	44W MAIN ST	FORDSVILLE	KY	Active
CAH181323-08	Child	CAH	Ohio County Hospital	BUTLER COUNTY FAMILY CARE	1238 S Main St	MORGANTOWN	KY	Approved
CAH181323-09	Child	CAH	Ohio County Hospital	Ohio County Hospital Corporation - Ohio County Healthcare Behavioral Health	1621 N. Main Street	Beaver Dam	KY	Active

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Contacts	Primary Contact	Update	Recertification	Ward, Barry A. Pharmacy Director Ohio County Hospital 2702985177	Ward, Barry Anthony Pharmacy Director Ohio County Hospital 2702985177	8/19/2024 12:19 PM
Details	Last Recertification Date	Update	Recertification	9/7/2023 10:44:37 AM	8/19/2024 12:19:02 PM	8/19/2024 12:19 PM
Details	Last Recertification Date	Update	Recertification		9/7/2023 10:44:37 AM	9/7/2023 10:44 AM
Contacts	Authorizing Official	Update	AO Change Request	Shouse, Shellie Dube CFO Ohio County Hospital 2705044050	Hibbs, Stuart Randall CFO OCH 2702985288	9/6/2023 4:18 PM
Details	State	Update		Approved	Active	10/1/2022 12:01 AM
Contacts	Signed By	Insert	New Registration		Shouse, Shellie Dube CFO Ohio County Hospital 2705044050	7/29/2022 6:36 AM
Details	340B ID	Update	New Registration		CAH181323-09	7/29/2022 6:36 AM
Details	Entity Name	Update	New Registration	OHIO COUNTY HOSPITAL	Ohio County Hospital	7/29/2022 6:36 AM
Details	Entity Subname	Update	New Registration	Ohio County Hospital Corporation	Ohio County Hospital Corporation - Ohio County Healthcare Behavioral Health	7/29/2022 6:36 AM
Dates	Participating Approval Date	Update	New Registration		7/29/2022 6:36:13 AM	7/29/2022 6:36 AM
Details	State	Update	New Registration	Pending	Approved	7/29/2022 6:36 AM
Dates	Signed By Date	Update	New Registration		7/28/2022 5:53:28 PM	7/29/2022 6:36 AM
Dates	Start Date	Update	New Registration		10/1/2022 12:00:00 AM	7/29/2022 6:36 AM
Addresses	Main Address	Insert	New Registration		1621 N. Main Street Beaver Dam, KY 42320	7/11/2022 3:17 PM
Contacts	Primary Contact	Insert	New Registration		Ward, Barry A. Pharmacy Director Ohio County Hospital 2702985177	7/11/2022 3:17 PM
Contacts	Authorizing Official	Insert	New Registration		Shouse, Shellie Dube CFO Ohio County Hospital 2705044050	7/11/2022 3:17 PM
Details	Assistance Received From Date	Insert	New Registration			7/11/2022 3:17 PM
Details	Assistance Received To Date	Insert	New Registration			7/11/2022 3:17 PM
Details	Last Recertification Date	Insert	New Registration			7/11/2022 3:17 PM
Details	Grant Number	Insert	New Registration			7/11/2022 3:17 PM
Details	340B ID	Insert	New Registration			7/11/2022 3:17 PM
Details	Is Authorizing Official EHB Data	Insert	New Registration			7/11/2022 3:17 PM
Dates	Last Date That 340B Drugs Purchased	Insert	New Registration			7/11/2022 3:17 PM
Details	Medicare Provider Number	Insert	New Registration		181323	7/11/2022 3:17 PM
Details	Entity Name	Insert	New Registration		OHIO COUNTY HOSPITAL	7/11/2022 3:17 PM
Details	NOFO Number	Insert	New Registration			7/11/2022 3:17 PM
Details	Program Code	Insert	New Registration		CAH	7/11/2022 3:17 PM
Details	Entity Subname	Insert	New Registration		Ohio County Hospital Corporation	7/11/2022 3:17 PM
Dates	Participating Approval Date	Insert	New Registration			7/11/2022 3:17 PM
Details	State	Insert	New Registration		Pending	7/11/2022 3:17 PM
Dates	Registration Date	Insert	New Registration		7/11/2022 3:17:54 PM	7/11/2022 3:17 PM
Dates	Signed By Date	Insert	New Registration			7/11/2022 3:17 PM
Dates	Start Date	Insert	New Registration			7/11/2022 3:17 PM
Terminations	Termination Comments	Insert	New Registration			7/11/2022 3:17 PM
Terminations	Termination Date	Insert	New Registration			7/11/2022 3:17 PM
Terminations	Termination Effective Date	Insert	New Registration			7/11/2022 3:17 PM
Terminations	Termination Reason	Insert	New Registration			7/11/2022 3:17 PM