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HOWARD FAMILY PHARMACY, INC.
CAH181305-03 ARH OUR LADY OF THE WAY
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Covered Entity Details
Entity Name
ARH OUR LADY OF THE WAY
Subdivision Name
ARH PRIMARY CARE ASSOCIATES NJ - Martin
Type
Critical Access Hospital
340B ID
CAH181305-03
Entity Address
12579 MAIN STREET
STE 101
MARTIN, KY 41649
Medicare Provider Number
181305
Outpatient Facility Provider Number
Participating Start Date
9/24/2010
Last Recertification Date
9/3/2024
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
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