Contract Pharmacy Details

UK - SPECIALTY PHARMACY
HM40831 UNIVERSITY OF KENTUCKY HEMOPHILIA TREATMENT CENTER

Covered Entity Details

Entity Name

UNIVERSITY OF KENTUCKY HEMOPHILIA TREATMENT CENTER

Subdivision Name

Outreach clinic : Harlan KY

Type

Comprehensive Hemophilia Treatment Center

340B ID

HM40831

Entity Address

Mountain Comprehensive Care/ Harlan Medical Clinic
132 Village Center
Harlan, KY 40831

Grant Number

H30MC24046

Participating Start Date

1/1/2018

Last Recertification Date

2/7/2022

Entity Termination Date

4/1/2023

Pharmacy Details

Pharmacy Name

UK - SPECIALTY PHARMACY

Pharmacy Address

UNIVERSITY OF KENTUCKY HOSPITAL
800 ROSE ST RM HC 201
RM HC201
LEXINGTON, KY 40536-7001

Pharmacy Comments

Contract Details

Approval Date

4/12/2018

Contract Begin Date

7/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/26/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Vlad Calin Radulescu, Medical Director
(859) 323-7832

Contract Pharmacy Representative

UK Specialty Pharmacy
Debbie Duckworth, Director of Specialty Pharmacy Services
(859) 257-8552

Signed By Date

4/12/2018

340B Drug Pricing Program Database