Contract Pharmacy Details

DYER DRUG
DSH180106 The Medical Center at Albany

Covered Entity Details

Entity Name

The Medical Center at Albany

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH180106

Entity Address

723 BURKESVILLE ROAD
ALBANY, KY 42602

Medicare Provider Number

180106

Participating Start Date

1/1/2010

Last Recertification Date

9/7/2023

Entity Termination Date

1/1/2024

Pharmacy Details

Pharmacy Name

DYER DRUG

Pharmacy Address

100 E CUMBERLAND ST
ALBANY, KY 42602

Pharmacy Comments

Contract Details

Approval Date

8/8/2011

Contract Begin Date

8/8/2011

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/23/2017
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

340B Drug Pricing Program Database