Contract Pharmacy Details

KENTUCKY CENTRAL FILL FACILITY, L-010
CAH181319-00 BRECKINRIDGE HEALTH, INC.

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

KENTUCKY CENTRAL FILL FACILITY, L-010

Pharmacy Address

5594 SHEPHERDSVILLE ROAD
LOUISVILLE, KY 40228-1012

Pharmacy Comments

Contract Details

Approval Date

7/8/2020

Contract Begin Date

7/14/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/18/2021
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Amy Arndell, Chief Financial Officer
(270) 756-6655

Contract Pharmacy Representative

Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875

Signed By Date

7/8/2020

340B Drug Pricing Program Database