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FLENER, INC.
DSH180017 TJ SAMSON COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
TJ SAMSON COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180017
Entity Address
1301 NORTH RACE STREET
GLASGOW, KY 42141
Medicare Provider Number
180017
Participating Start Date
7/1/2005
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
FLENER, INC.
Pharmacy Address
DBA PHARMACY EXPRESS
415 S L ROGERS WELLS BLVD
GLASGOW, KY 42141-1191
Pharmacy Comments
Contract Details
Approval Date
6/20/2012
Contract Begin Date
6/20/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
BILL KINDRED, CEO
(270) 651-4159
Contract Pharmacy Representative
Alan Flener, President
(270) 651-7948
Signed By Date
6/8/2012
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