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HOMETOWN PHARMACY OF JACKSON
CH043828B JUNIPER HEALTH, INC.
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Covered Entity Details
Entity Name
JUNIPER HEALTH, INC.
Subdivision Name
Juniper Health Breathitt County
Type
HRSA-Funded Health Center
340B ID
CH043828B
Entity Address
1484 Lakeside Dr
Jackson, KY 41339-7370
Grant Number
H80CS04203
Participating Start Date
10/1/2006
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
HOMETOWN PHARMACY OF JACKSON
Pharmacy Address
95 JACKSON HTS
JACKSON, KY 41339-6500
Pharmacy Comments
Contract Details
Approval Date
10/14/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen Ditsch, Chief Executive Officer
(606) 464-0151
Contract Pharmacy Representative
Family Pharmacy
Everett Dunaway, Owner/Pharmacist
(606) 666-5500
Signed By Date
10/14/2014
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