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RX DISCOUNT PHARMACY
DSH180029 HAZARD ARH REGIONAL MEDICAL CENTER
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Covered Entity Details
Entity Name
HAZARD ARH REGIONAL MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH180029
Entity Address
100 MEDICAL CENTER DRIVE
HAZARD, KY 41701
Medicare Provider Number
180029
Participating Start Date
10/1/2004
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
RX DISCOUNT PHARMACY
Pharmacy Address
500 MORTON BLVD.
HAZARD, KY 41701
Pharmacy Comments
Contract Details
Approval Date
1/11/2018
Contract Begin Date
4/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2019
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Contract Pharmacy Representative
Rx Discount Pharmacy
Richard Slone, Pharmacist/Owner
(606) 436-2891
Signed By Date
1/11/2018
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