Contract Pharmacy Details

HOMETOWN PHARMACY OF JACKSON
CH0438280 JUNIPER HEALTH, INC.

Covered Entity Details

Entity Name

JUNIPER HEALTH, INC.

Subdivision Name

JUNIPER HEALTH, INC.

Type

HRSA-Funded Health Center

340B ID

CH0438280

Entity Address

141 Main St
BEATTYVILLE, KY 41311

Grant Number

H80CS04203

Participating Start Date

4/1/2005

Last Recertification Date

2/17/2025

Pharmacy Details

Pharmacy Name

HOMETOWN PHARMACY OF JACKSON

Pharmacy Address

95 JACKSON HTS
JACKSON, KY 41339-6500

Pharmacy Comments

Contract Details

Approval Date

10/12/2017

Contract Begin Date

1/1/2018

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Karen Ditsch, Chief Executive Officer
(606) 464-0151

Contract Pharmacy Representative

Family Pharmacy
Everett Dunaway, Owner/Pharmacist
(606) 666-5500

Signed By Date

10/12/2017

340B Drug Pricing Program Database