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PHARMACY CARE CENTER
DSH180029 HAZARD ARH REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
HAZARD ARH REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180029
Entity Address
100 MEDICAL CENTER DRIVE
HAZARD, KY 41701
Medicare Provider Number
180029
Participating Start Date
10/1/2004
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
PHARMACY CARE CENTER
Pharmacy Address
101 TOWN AND COUNTRY LN
SUITE 101
HAZARD, KY 41701-4170
Pharmacy Comments
Contract Details
Approval Date
7/7/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/26/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Contract Pharmacy Representative
Primary Care Centers of Eastern Kentucky, LLC
Wesley Huff, Director of Pharmacy
(606) 435-0460 Ext: 4406
Signed By Date
7/7/2020
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