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JEWISH HOSPITAL & ST. MARYS HEALTHCARE I
DSH180143 SAINT JOSEPH EAST
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Covered Entity Details
Entity Name
SAINT JOSEPH EAST
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180143
Entity Address
150 NORTH EAGLE CREEK DRIVE
LEXINGTON, KY 40509
Medicare Provider Number
180143
Participating Start Date
1/1/2008
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
JEWISH HOSPITAL & ST. MARYS HEALTHCARE I
Pharmacy Address
DBA PHARMACY PLUS SPECIALTY
5111 COMMERCE CROSSINGS DRIVE STE 120
LOUISVILLE, KY 40229
Pharmacy Comments
Contract Details
Approval Date
7/7/2015
Contract Begin Date
10/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/4/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Mendy Evans, VP Finance
(859) 313-1694
Contract Pharmacy Representative
Jim Hurley, Director
(502) 561-3900
Signed By Date
7/7/2015
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