Contract Pharmacy Details

RICE DRUGS INC
CAH181323-00 Ohio County Hospital

Covered Entity Details

Entity Name

Ohio County Hospital

Subdivision Name

Type

Critical Access Hospital

340B ID

CAH181323-00

Entity Address

1211 Old Main Street
Hartford, KY 42347-1619

Medicare Provider Number

181323

Participating Start Date

10/1/2011

Last Recertification Date

8/19/2024

Pharmacy Details

Pharmacy Name

RICE DRUGS INC

Pharmacy Address

1209 N MAIN ST
BEAVER DAM, KY 42320-8955

Pharmacy Comments

Contract Details

Approval Date

2/23/2012

Contract Begin Date

2/23/2012

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

John Tichenor, CFO
(270) 298-5495

Contract Pharmacy Representative

David Figg, COO
(270) 274-3318

Signed By Date

2/16/2012