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WAL-MART PHARMACY #10-1139
CAH181307-00 APPALACHIAN REGIONAL HEALTHCARE INC. D/B/A MORGAN CO. ARH HOSPITAL
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Covered Entity Details
Entity Name
APPALACHIAN REGIONAL HEALTHCARE INC. D/B/A MORGAN CO. ARH HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181307-00
Entity Address
476 LIBERTY ROAD
WEST LIBERTY, KY 41472
Medicare Provider Number
181307
Participating Start Date
9/8/2010
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY #10-1139
Pharmacy Address
200 WAL-MART WAY
MOREHEAD, KY 40351
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
1/10/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/12/2019
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