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PROCARE PHARMACY DIRECT, L.L.C.
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
PROCARE PHARMACY DIRECT, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146
Pharmacy Comments
12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)
Contract Details
Approval Date
4/5/2023
Contract Begin Date
4/10/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Thomas Carrico, Chief Operating Officer
(270) 706-5321
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/5/2023
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