340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MARROWBONE FAMILY PHARMACY, LLC
DSH180044 PIKEVILLE MEDICAL CENTER, INC.
Print
Covered Entity Details
Entity Name
PIKEVILLE MEDICAL CENTER, INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180044
Entity Address
911 BYPASS ROAD
PIKEVILLE, KY 41501
Medicare Provider Number
180044
Participating Start Date
1/1/2007
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
MARROWBONE FAMILY PHARMACY, LLC
Pharmacy Address
RUSSELL FORK PHARMACY
10363 REGINA / BELCHER HWY
ELKHORN CITY, KY 41522
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/18/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
MICHELLE HAGY, CFO
(606) 430-3519
Contract Pharmacy Representative
Russell Fork Pharmacy
Chris Johnson, Owner
(606) 754-7085
Signed By Date
7/12/2019
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