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CLARK DRUGS
CAH181314-00 The Medical Center at Caverna
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Covered Entity Details
Entity Name
The Medical Center at Caverna
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181314-00
Entity Address
1501 South Dixie Street
Horse Cave, KY 42749
Medicare Provider Number
181314
Participating Start Date
10/1/2011
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
CLARK DRUGS
Pharmacy Address
CLARK DRUGS
500 MAIN ST
MUNFORDVILLE, KY 42765
Pharmacy Comments
Contract Details
Approval Date
1/6/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Wade R. Stone, Executive Vice President
(270) 745-1504
Contract Pharmacy Representative
Clark Drugs
Alan Flener, Owner
(270) 889-4009
Signed By Date
1/6/2023
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