340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KB PHARMACY, LLC
DSH180095 CRITTENDEN COUNTY HOSPITAL INC.
Print
Covered Entity Details
Entity Name
CRITTENDEN COUNTY HOSPITAL INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180095
Entity Address
520 W Gum St
MARION, KY 42064
Medicare Provider Number
180095
Participating Start Date
7/1/2018
Last Recertification Date
8/17/2018
Entity Termination Date
1/1/2019
Pharmacy Details
Pharmacy Name
KB PHARMACY, LLC
Pharmacy Address
320 S MAIN ST
PO BOX 437
MARION, KY 42064-1545
Pharmacy Comments
Contract Details
Approval Date
7/17/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/1/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Daniel John Hiben, Chief Executive Officer
(270) 965-1018
Contract Pharmacy Representative
KB Pharmacy
Brad Boone, Pharmacist
(270) 967-9007
Signed By Date
7/17/2018
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