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TOTAL PHARMACY CARE OF BELFRY
DSH180044 PIKEVILLE MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
PIKEVILLE MEDICAL CENTER, INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180044
Entity Address
911 BYPASS ROAD
PIKEVILLE, KY 41501
Medicare Provider Number
180044
Participating Start Date
1/1/2007
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
TOTAL PHARMACY CARE OF BELFRY
Pharmacy Address
20 STATE HIGHWAY 319
BELFRY, KY 41514-8678
Pharmacy Comments
Contract Details
Approval Date
7/15/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MICHELLE HAGY, CFO
(606) 430-3519
Contract Pharmacy Representative
Total Pharmacy Care
Billy Rowe, President
(606) 433-0555
Signed By Date
7/15/2024
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