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CURANT HEALTH GEORGIA LLC
CAH531310-00 Powell Valley Healthcare
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Covered Entity Details
Entity Name
Powell Valley Healthcare
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH531310-00
Entity Address
777 Ave H
Powell, WY 82435
Medicare Provider Number
531310
Participating Start Date
1/1/2012
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
CURANT HEALTH GEORGIA LLC
Pharmacy Address
CURANT HEALTH
200 TECHNOLOGY CT SE BLDG 200
SUITE B
SMYRNA, GA 30082-5250
Pharmacy Comments
12/21/2012 address update (was 1270 WINCHESTER PKWY, STE 100 30080)
Contract Details
Approval Date
4/21/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/8/2015
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Bill Patten, CEO
(307) 754-1101
Contract Pharmacy Representative
Curant Health
Patrick Dunham, President & CEO
(866) 437-8040 Ext: 232
Signed By Date
4/21/2014
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