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G & O PHARMACY OF PADUCAH
HV420021 LivWell Community Health Services, Inc.
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Covered Entity Details
Entity Name
LivWell Community Health Services, Inc.
Subdivision Name
Type
Ryan White Part C
340B ID
HV420021
Entity Address
1903 Broadway Street
PADUCAH, KY 42001
Grant Number
H76HA00208
Participating Start Date
10/1/1998
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
G & O PHARMACY OF PADUCAH
Pharmacy Address
G & O PHARMACY OF PADUCAH
2338 BROADWAY ST
PADUCAH, KY 42001
Pharmacy Comments
Contract Details
Approval Date
4/16/2003
Contract Begin Date
4/16/2003
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
8/3/2020
Agreement registered in error
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
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