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BAPTIST HEALTH SHARED SERVICES PHARMACY
RRC180104-00 BAPTIST HEALTH PADUCAH
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Covered Entity Details
Entity Name
BAPTIST HEALTH PADUCAH
Subdivision Name
Type
Rural Referral Center
340B ID
RRC180104-00
Entity Address
2501 KENTUCKY AVENUE
PADUCAH, KY 42003
Medicare Provider Number
180104
Participating Start Date
1/1/2025
Last Recertification Date
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
4/1/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kenneth Boyd, President
(270) 575-2101
Contract Pharmacy Representative
baptist health
jordan marcus propst, director, central pharmacy
(864) 490-7827
Signed By Date
4/1/2025
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