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KENTUCKY CVS PHARMACY, L.L.C.
DSH180049 BAPTIST HEALTH RICHMOND
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Covered Entity Details
Entity Name
BAPTIST HEALTH RICHMOND
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180049
Entity Address
801 EASTERN BYPASS
RICHMOND, KY 40475
Medicare Provider Number
180049
Participating Start Date
10/1/2016
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
KENTUCKY CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06346
409 EAST MAIN STREET
RICHMOND, KY 40475
Pharmacy Comments
Contract Details
Approval Date
1/5/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Greg Gerard, President
(859) 625-3114
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/5/2024
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