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ST. MATTHEWS SPECIALTY PHARMACY
DSH180087 TAYLOR COUNTY HOSPITAL DISTRICT
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Covered Entity Details
Entity Name
TAYLOR COUNTY HOSPITAL DISTRICT
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180087
Entity Address
1700 OLD LEBANON ROAD
CAMPBELLSVILLE, KY 42718
Medicare Provider Number
180087
Participating Start Date
10/1/2004
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
ST. MATTHEWS SPECIALTY PHARMACY
Pharmacy Address
DBA ST. MATTHEWS SPECIALTY PHARMACY
200 N HURSTBOURNE PKWY STE 176
LOUISVILLE, KY 40222
Pharmacy Comments
Contract Details
Approval Date
10/7/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
CATHERINE SETTLE, CLINICAL SERVICES ADMINISTRATOR
(270) 789-6178
Contract Pharmacy Representative
Taylor Regional Hospital
ERIC SPROWLES, DIRECTOR OF PHARMACY
(270) 465-3561
Signed By Date
10/7/2019
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