Contract Pharmacy Details

HOWARD FAMILY PHARMACY, INC.
CAH181305-02 ARH OUR LADY OF THE WAY

Covered Entity Details

Entity Name

ARH OUR LADY OF THE WAY

Subdivision Name

ARH PRIMARY CARE ASSOCIATES NK Betsy Layne

Type

Critical Access Hospital

340B ID

CAH181305-02

Entity Address

9350 US HIGHWAY 23 S
STE 3
STANVILLE, KY 41659

Medicare Provider Number

181305

Outpatient Facility Provider Number

Participating Start Date

9/24/2010

Last Recertification Date

9/4/2019

Entity Termination Date

4/1/2020

Pharmacy Details

Pharmacy Name

HOWARD FAMILY PHARMACY, INC.

Pharmacy Address

327 KY ROUTE 550
EASTERN, KY 41622-6925

Pharmacy Comments

Contract Details

Approval Date

8/15/2012

Contract Begin Date

8/15/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/11/2016
Agreement registered in error

Contacts

Covered Entity Signing Official

Kathy Stumbo, CEO
(606) 285-6401

Contract Pharmacy Representative

Howard Family Pharmacy
Wes Howard, Owner
(606) 358-4800

Signed By Date

7/9/2012

340B Drug Pricing Program Database