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WAL-MART PHARMACY 10-0445
CAH181319-00 BRECKINRIDGE HEALTH, INC.
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Covered Entity Details
Entity Name
BRECKINRIDGE HEALTH, INC.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181319-00
Entity Address
1011 OLD HIGHWAY 60
HARDINSBURG, KY 40143
Medicare Provider Number
181319
Participating Start Date
7/1/2011
Last Recertification Date
8/26/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-0445
Pharmacy Address
1801 ELIZABETHTOWN RD
LEITCHFIELD, KY 42754
Pharmacy Comments
Contract Details
Approval Date
7/8/2020
Contract Begin Date
7/14/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Amy Arndell, Chief Financial Officer
(270) 756-6655
Contract Pharmacy Representative
Walmart
Julie Howard, 340B Program Manager
(479) 277-1498
Signed By Date
7/8/2020
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