340B Drug Pricing Program Database
BAPTIST HEALTH SHARED SERVICES PHARMACY
DSH180104 BAPTIST HEALTH PADUCAH - information as of 5/4/2025 11:38:41 PM
Covered Entity Details
Entity Name
BAPTIST HEALTH PADUCAH
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180104
Entity Address
2501 KENTUCKY AVENUE
PADUCAH, KY 42003
Medicare Provider Number
180104
Participating Start Date
4/1/2016
Last Recertification Date
8/30/2024
Entity Termination Date
1/1/2025
Pharmacy Details
Pharmacy Name
BAPTIST HEALTH SHARED SERVICES PHARMACY
Pharmacy Address
1051 NEW MOODY LN STE 1400
LA GRANGE, KY 40031
Pharmacy Comments
Contract Details
Approval Date
4/10/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2025
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Kenneth Boyd, President
(270) 575-2101
Contract Pharmacy Representative
baptist health
jordan marcus propst, director, central pharmacy
(864) 490-7827
Signed By Date
4/10/2024
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