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KENTUCKY CVS PHARMACY, L.L.C.
DSH180078 ARH TUG VALLEY HEALTH SERVICES, INC. DBA PAINTSVILLE ARH HOSPITAL
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Covered Entity Details
Entity Name
ARH TUG VALLEY HEALTH SERVICES, INC. DBA PAINTSVILLE ARH HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180078
Entity Address
625 James Trimble Blvd
PAINTSVILLE, KY 41240
Medicare Provider Number
180078
Participating Start Date
2/22/2022
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
KENTUCKY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06346
409 EAST MAIN STREET
RICHMOND, KY 40475
Pharmacy Comments
Contract Details
Approval Date
7/15/2022
Contract Begin Date
10/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Hollie P Harris, President & CEO
(859) 226-2511
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/15/2022
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