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AVELLA OF DEER VALLEY, INC. #38
CAH181307-00 APPALACHIAN REGIONAL HEALTHCARE INC. D/B/A MORGAN CO. ARH HOSPITAL
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Covered Entity Details
Entity Name
APPALACHIAN REGIONAL HEALTHCARE INC. D/B/A MORGAN CO. ARH HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH181307-00
Entity Address
476 LIBERTY ROAD
WEST LIBERTY, KY 41472
Medicare Provider Number
181307
Participating Start Date
9/8/2010
Last Recertification Date
9/6/2024
Pharmacy Details
Pharmacy Name
AVELLA OF DEER VALLEY, INC. #38
Pharmacy Address
DBA AVELLA SPECIALTY PHARMACY
24416 N. 19TH AVE
PHOENIX, AZ 85085
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
6/30/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Contract Pharmacy Representative
Avella
Nancy McCutcheon, Senior Vice President, Strategic Services
(651) 983-0677
Signed By Date
1/11/2018
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