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UK - SPECIALTY 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
UK - SPECIALTY PHARMACY
Pharmacy Address
UNIVERSITY OF KENTUCKY HOSPITAL
800 ROSE ST RM HC 201
RM HC201
LEXINGTON, KY 40536-7001
Pharmacy Comments
Contract Details
Approval Date
10/13/2016
Contract Begin Date
1/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/17/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Chris McClurg, VP FINANCIAL SERVICES/CFO
(606) 783-6587
Contract Pharmacy Representative
UK Specialty Pharmacy
Debbie Duckworth, Director of Specialty Pharmacy Services
(859) 257-8552
Signed By Date
10/13/2016
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