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BAPTIST HEALTH SHARED SERVICES PHARMACY
DSH180103 Baptist Health Lexington
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Covered Entity Details
Entity Name
Baptist Health Lexington
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180103
Entity Address
1740 NICHOLASVILLE ROAD
LEXINGTON, KY 40503
Medicare Provider Number
180103
Participating Start Date
7/1/2007
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
BAPTIST HEALTH SHARED SERVICES PHARMACY
Pharmacy Address
1051 NEW MOODY LN STE 1400
LA GRANGE, KY 40031
Pharmacy Comments
Contract Details
Approval Date
4/3/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher M. Roty, President
(859) 260-6104
Contract Pharmacy Representative
baptist health
jordan marcus propst, director, central pharmacy
(864) 490-7827
Signed By Date
4/3/2024
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