Contract Pharmacy Details

WEBSTER DRUGS
CAH181312-02 NEW HORIZON MEDICAL CENTER

Covered Entity Details

Entity Name

NEW HORIZON MEDICAL CENTER

Subdivision Name

NEW HORIZON HEALTH SYSTEMS, INC.

Type

Critical Access Hospital

340B ID

CAH181312-02

Entity Address

330 ROLAND AVENUE
OWENTON, KY 40359

Medicare Provider Number

181312

Outpatient Facility Provider Number

Participating Start Date

9/30/2010

Last Recertification Date

9/8/2016

Entity Termination Date

10/1/2016

Pharmacy Details

Pharmacy Name

WEBSTER DRUGS

Pharmacy Address

99 PARKLANES SHOPPING CENTER
PO BOX 311
CARROLLTON, KY 41008

Pharmacy Comments

Contract Details

Approval Date

10/20/2011

Contract Begin Date

12/21/2010

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

10/1/2016

Contacts

Covered Entity Signing Official

Contract Pharmacy Representative

Signed By Date

12/6/2010

340B Drug Pricing Program Database