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Kroger Pharmacy
CAH181328-00 ARH Mary Breckinridge Health Services, Inc.
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Covered Entity Details
Entity Name
ARH Mary Breckinridge Health Services, Inc.
Subdivision Name
Barbourville ARH Hospital
Type
Critical Access Hospital
340B ID
CAH181328-00
Entity Address
80 HOSPITAL DRIVE
BARBOURVILLE, KY 40906
Medicare Provider Number
181328
Participating Start Date
1/1/2016
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
Kroger Pharmacy
Pharmacy Address
Jeffersonville Central Fill Facility
301 Logistics Ave
Suite 200
Jeffersonville, IN 47130
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Maria Braman, Chief Medical Officer
(406) 465-8506
Contract Pharmacy Representative
Kroger Health
Eva Brumfield, Strategic Program Director
(651) 357-2109
Signed By Date
10/16/2023
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