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HEALTHY WAY PHARMACY
DSH180018 ST CLAIRE MEDICAL CENTER INC
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Covered Entity Details
Entity Name
ST CLAIRE MEDICAL CENTER INC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180018
Entity Address
222 MEDICAL CIRCLE
MOREHEAD, KY 40351
Medicare Provider Number
180018
Participating Start Date
1/1/2005
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
HEALTHY WAY PHARMACY
Pharmacy Address
432 S. KY 7 RT. 7 MAIN STREET
PO BOX 492
SANDY HOOK, KY 41171
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Chris McClurg, VP FINANCIAL SERVICES/CFO
(606) 783-6587
Contract Pharmacy Representative
Healthy Way
John Dickerson, Primary Contact
(606) 738-4041
Signed By Date
7/15/2019
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