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COMMUNITY PHARMACY AT SAINT JOSEPH HOSPI
DSH180143 SAINT JOSEPH EAST
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Covered Entity Details
Entity Name
SAINT JOSEPH EAST
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180143
Entity Address
150 NORTH EAGLE CREEK DRIVE
LEXINGTON, KY 40509
Medicare Provider Number
180143
Participating Start Date
1/1/2008
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
COMMUNITY PHARMACY AT SAINT JOSEPH HOSPI
Pharmacy Address
1401 HARRODSBURG RD STE B375
LEXINGTON, KY 40504
Pharmacy Comments
Contract Details
Approval Date
7/17/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/24/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Lonnie Ralph Taylor, VP Patient Care Services/Operations
(859) 967-5758
Contract Pharmacy Representative
CHI Saint Joseph Health
Marla Whitaker, Director of Pharmacy
(859) 313-2056
Signed By Date
7/17/2020
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