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KENTUCKY CENTRAL FILL FACILITY, L-010
CHC09959-00 GRACE COMMUNITY HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
GRACE COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Grace Community Health Center, Inc
Type
HRSA-Funded Health Center
340B ID
CHC09959-00
Entity Address
39 Cumberland Gap Plaza
Gray, KY 40734
Grant Number
H80CS09959
Participating Start Date
10/1/2010
Last Recertification Date
2/1/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
KENTUCKY CENTRAL FILL FACILITY, L-010
Pharmacy Address
5594 SHEPHERDSVILLE ROAD
LOUISVILLE, KY 40228-1012
Pharmacy Comments
Contract Details
Approval Date
10/12/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/9/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
Michael W Stanley, Chief Executive Officer
(606) 526-9005
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/12/2019
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