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EXPRESS SCRIPTS PHARMACY, INC.
DSH180067 UNIVERSITY OF KENTUCKY
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Covered Entity Details
Entity Name
UNIVERSITY OF KENTUCKY
Subdivision Name
UK Chandler Hospital
Type
Disproportionate Share Hospital
340B ID
DSH180067
Entity Address
800 ROSE STREET
LEXINGTON, KY 40536
Medicare Provider Number
180067
Participating Start Date
12/1/1992
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
EXPRESS SCRIPTS PHARMACY, INC.
Pharmacy Address
DBA EXPRESS SCRIPTS
2040 ROUTE 130 NORTH
BURLINGTON, NJ 08016
Pharmacy Comments
Contract Details
Approval Date
4/15/2016
Contract Begin Date
7/1/2016
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/27/2017
Covered Entity Terminated
Contacts
Covered Entity Signing Official
ANN SMITH, CHIEF ADMINISTRATIVE OFFICER
(859) 323-5470
Contract Pharmacy Representative
Express Scripts
Lynda Doremus, Pharmacist In Charge
(609) 880-2393
Signed By Date
4/15/2016
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