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BENTON DISCOUNT PHARMACY
CAH181320-00 Livingston Hospital and Healthcare Services, Inc.
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Covered Entity Details
Entity Name
Livingston Hospital and Healthcare Services, Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181320-00
Entity Address
131 Hospital Drive
Salem, KY 42078
Medicare Provider Number
181320
Participating Start Date
7/1/2014
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
BENTON DISCOUNT PHARMACY
Pharmacy Address
DBA/DRAFFENVILLE PHARMACY
153 US HIGHWAY 68 E
BENTON, KY 42025-7123
Pharmacy Comments
Contract Details
Approval Date
4/24/2014
Contract Begin Date
7/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/1/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Elizabeth Snodgrass, CEO
(270) 988-7235
Contract Pharmacy Representative
APEX
Harold Beck, President
(270) 527-1409
Signed By Date
4/24/2014
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