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FRENCHBURG PHARMACY
DSH180018 ST CLAIRE MEDICAL CENTER INC
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Covered Entity Details
Entity Name
ST CLAIRE MEDICAL CENTER INC
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180018
Entity Address
222 MEDICAL CIRCLE
MOREHEAD, KY 40351
Medicare Provider Number
180018
Participating Start Date
1/1/2005
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
FRENCHBURG PHARMACY
Pharmacy Address
732 HIGHWAY 36
FRENCHBURG, KY 40322
Pharmacy Comments
Contract Details
Approval Date
2/2/2012
Contract Begin Date
2/2/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
G.R. JONES, VP FINANCIAL SERVICES/CFO
(606) 783-6508
Contract Pharmacy Representative
Deborah Brewer, President
(606) 738-5111
Signed By Date
1/20/2012
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