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COFFMAN AND HART LLC DBA PROVIDENCE PHAR
CHC17157-02 REGIONAL HEALTH CARE AFFILIATES, INC.
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Covered Entity Details
Entity Name
REGIONAL HEALTH CARE AFFILIATES, INC.
Subdivision Name
Regional Health Care Affiliates, Inc. Doing Business As Health First CHC - Clay
Type
HRSA-Funded Health Center
340B ID
CHC17157-02
Entity Address
140 Veterans Memorial Ave.
Clay, KY 42404
Grant Number
H80CS17157
Participating Start Date
10/1/2013
Last Recertification Date
2/13/2025
Pharmacy Details
Pharmacy Name
COFFMAN AND HART LLC DBA PROVIDENCE PHAR
Pharmacy Address
2141 WESTERFIELD DR
PROVIDENCE, KY 42450
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Shelley Renea Gobin, CEO
(270) 667-2535 Ext: 2104
Contract Pharmacy Representative
Coffman and Hart LLC
Adam Coffman, owner/pharmacist
(270) 676-8268
Signed By Date
1/13/2023
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