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HOWARD FAMILY PHARMACY, INC.
DSH180005 HIGHLANDS ARH REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
HIGHLANDS ARH REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180005
Entity Address
5000 KY RT 321
PRESTONSBURG, KY 41653
Medicare Provider Number
180005
Participating Start Date
9/9/2005
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
HOWARD FAMILY PHARMACY, INC.
Pharmacy Address
327 KY ROUTE 550
EASTERN, KY 41622-6925
Pharmacy Comments
Contract Details
Approval Date
1/14/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/30/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
JACK BLACKWELL, CFO
(606) 886-8511
Contract Pharmacy Representative
Howard Family Pharmacy
Wes Howard, Owner
(606) 358-4800
Signed By Date
1/14/2015
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