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KAY'S PHARMACY
CAH171340-00 Herington Hospital, Inc. d/b/a Herington Hospital
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Covered Entity Details
Entity Name
Herington Hospital, Inc. d/b/a Herington Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171340-00
Entity Address
100 EAST HELEN
HERINGTON, KS 67449
Medicare Provider Number
171340
Participating Start Date
1/1/2019
Last Recertification Date
8/31/2023
Entity Termination Date
10/1/2024
Pharmacy Details
Pharmacy Name
KAY'S PHARMACY
Pharmacy Address
RIVERVIEW ENTERPRISES INC.
2 W MAIN ST
HERINGTON, KS 67449
Pharmacy Comments
Contract Details
Approval Date
1/14/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/1/2019
Agreement registered in error
Contacts
Covered Entity Signing Official
Isabel S Schmedemann, CEO
(785) 258-5132
Contract Pharmacy Representative
Kay's Pharmacy
David Rziha, Owner
(785) 258-3703
Signed By Date
1/14/2019
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