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BAPTIST HEALTH LEXINGTON RETAIL PHARMACY
DSH180012 Baptist Health Hardin
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Covered Entity Details
Entity Name
Baptist Health Hardin
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180012
Entity Address
913 NORTH DIXIE AVENUE
ELIZABETHTOWN, KY 42701
Medicare Provider Number
180012
Participating Start Date
4/1/2017
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
BAPTIST HEALTH LEXINGTON RETAIL PHARMACY
Pharmacy Address
1700 NICHOLASVILLE RD STE N1210
LEXINGTON, KY 40503-1463
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Carrico, Chief Operating Officer
(270) 706-5321
Contract Pharmacy Representative
Baptist Health Lexington
Michael Anderson, Director of Pharmacy
(859) 260-6498
Signed By Date
4/15/2022
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