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PARKWAY PHARMACY
BL040600 MOUNTAIN COMPREHENSIVE HEALTH CORP.
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Covered Entity Details
Entity Name
MOUNTAIN COMPREHENSIVE HEALTH CORP.
Subdivision Name
WHITESBURG MEDICAL CLINIC
Type
Black Lung Clinics Program
340B ID
BL040600
Entity Address
226 MEDICAL PLAZA LANE
WHITESBURG, KY 41858
Grant Number
H37RH00050
Participating Start Date
10/1/2004
Last Recertification Date
2/24/2025
Pharmacy Details
Pharmacy Name
PARKWAY PHARMACY
Pharmacy Address
2354 HIGHWAY 15
PARKWAY PHARMACY
WHITESBURG, KY 41858-7413
Pharmacy Comments
Contract Details
Approval Date
4/2/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
L.M. Caudill, CEO
(606) 633-4823
Contract Pharmacy Representative
Harlan Medical Center
Ernie Watts, Owner/Operator
(606) 589-0003
Signed By Date
4/2/2015
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