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ST JOSEPH'S MCAULEY PHARMACY
DSH180064 SAINT JOSEPH HEALTH SYSTEM, INC. DBA SAINT JOSEPH MOUNT STERLING
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Covered Entity Details
Entity Name
SAINT JOSEPH HEALTH SYSTEM, INC. DBA SAINT JOSEPH MOUNT STERLING
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180064
Entity Address
225 Falcon Drive
MT. STERLING, KY 40353
Medicare Provider Number
180064
Participating Start Date
12/1/2005
Last Recertification Date
8/20/2024
Pharmacy Details
Pharmacy Name
ST JOSEPH'S MCAULEY PHARMACY
Pharmacy Address
500 W. THOMAS ROAD
SUITE 190
PHOENIX, AZ 85013
Pharmacy Comments
Contract Details
Approval Date
1/14/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
4/30/2021
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Jennifer C Nolan, President
(502) 350-5044
Contract Pharmacy Representative
St. Joseph's Hospital and Medical Center
Greg Blank, Director of Pharmacy
(602) 406-4744
Signed By Date
1/14/2021
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