340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KENTUCKY CVS PHARMACY, L.L.C.
CAH181316-00 ARH MARY BRECKINRIDGE HEALTH SERVICES, INC. DBA MARY BRECKINRIDGE ARH HOSPITAL
Print
Covered Entity Details
Entity Name
ARH MARY BRECKINRIDGE HEALTH SERVICES, INC. DBA MARY BRECKINRIDGE ARH HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181316-00
Entity Address
130 KATE IRELAND DRIVE
HYDEN, KY 41749
Medicare Provider Number
181316
Participating Start Date
10/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
KENTUCKY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06343
30 S KY HIGHWAY 15
HAZARD, KY 41701
Pharmacy Comments
Contract Details
Approval Date
7/7/2020
Contract Begin Date
7/9/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/1/2023
Pharmacy closed
Contacts
Covered Entity Signing Official
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/7/2020
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