340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
RRC180102-13 MERCY HEALTH LOURDES HOSPITAL LLC (Terminated)
Print
Main Details
Name
MERCY HEALTH LOURDES HOSPITAL LLC
Subdivision Name
PADUCAH DIAGNOSTIC CENTER / LMP Radiology
Type
Rural Referral Center
Rural
Yes
340B ID
RRC180102-13
Medicare Provider Number
180102
Outpatient Facility Provider Number
Additional Details
Current Program Status
Terminated
Registration Date
11/17/2016
Participating Start Date
1/1/2017
Participating Approval Date
12/8/2016
Last Recertification Date
11/6/2017
Termination Date
Termination Reason
10/1/2018
Business decision by the Covered Entity
Contacts
Authorizing Official
Lourdes Hospital
Alan Archbold, Chief Financial Officer Kentucky Region
(270) 444-2553
Primary Contact
Mercy Health Lourdes Hospital LLC
Keithen Branch, Director of Pharmacy
(270) 444-2774
Addresses
Street Address
225 MEDICAL CENTER DRIVE
SUITE 103
PADUCAH, KY 42003-7907
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
History
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
Comment
Last Updated On
1
Item
0
to
0
of
0
Page:
of 1
Go
Page size:
Change
No records to display.
May 2025
May 2025
week
S
M
T
W
T
F
S
18
27
28
29
30
1
2
3
19
4
5
6
7
8
9
10
20
11
12
13
14
15
16
17
21
18
19
20
21
22
23
24
22
25
26
27
28
29
30
31
23
1
2
3
4
5
6
7
NoFilter
Contains
DoesNotContain
StartsWith
EndsWith
EqualTo
NotEqualTo
GreaterThan
LessThan
GreaterThanOrEqualTo
LessThanOrEqualTo
Between
NotBetween
IsEmpty
NotIsEmpty
IsNull
NotIsNull
Custom
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session