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ST. MATTHEWS SPECIALTY PHARMACY
CAH151331-00 HARRISON COUNTY HOSPITAL
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Covered Entity Details
Entity Name
HARRISON COUNTY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH151331-00
Entity Address
1141 HOSPITAL DRIVE N.W
CORYDON, IN 47112
Medicare Provider Number
151331
Participating Start Date
8/4/2010
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
ST. MATTHEWS SPECIALTY PHARMACY
Pharmacy Address
DBA ST. MATTHEWS SPECIALTY PHARMACY
200 N HURSTBOURNE PKWY STE 176
LOUISVILLE, KY 40222
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
Lisa Marie Lieber, Chief Administrative Officer
(812) 738-7884
Contract Pharmacy Representative
St Matthews
Chad Downing, Director of 340B
(844) 552-9669
Signed By Date
1/5/2024
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