340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AETNA SPECIALTY PHARMACY, LLC
DSH170040 UNIVERSITY OF KANSAS HOSPITAL
Print
Covered Entity Details
Entity Name
UNIVERSITY OF KANSAS HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH170040
Entity Address
4000 Cambridge Street
Kansas City, KS 66160
Medicare Provider Number
170040
Participating Start Date
10/1/2000
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
AETNA SPECIALTY PHARMACY, LLC
Pharmacy Address
503 SUNPORT LN
ORLANDO, FL 32809-7874
Pharmacy Comments
Contract Details
Approval Date
7/15/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/19/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
Rick Couldry, Vice-President, Pharmacy and Clinical Professions
(913) 588-2301
Contract Pharmacy Representative
University of Kansas Health System
Michael Starling, 340B Operations Manager
(913) 574-0231
Signed By Date
7/15/2019
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