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RICE DRUGS INC
CAH181323-07 Ohio County Hospital
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Covered Entity Details
Entity Name
Ohio County Hospital
Subdivision Name
FORDSVILLE AREA MEDICAL CLINIC
Type
Critical Access Hospital
340B ID
CAH181323-07
Entity Address
44W MAIN ST
FORDSVILLE, KY 42343-9761
Medicare Provider Number
181323
Outpatient Facility Provider Number
183408
Participating Start Date
1/1/2015
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
RICE DRUGS INC
Pharmacy Address
1209 N MAIN ST
BEAVER DAM, KY 42320-8955
Pharmacy Comments
Contract Details
Approval Date
10/15/2020
Contract Begin Date
1/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shellie Dube Shouse, CFO
(270) 504-4050
Contract Pharmacy Representative
Ohio County Hospital
Barry Anthony Ward, Pharmacy Director
(270) 298-5177
Signed By Date
10/15/2020
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