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UK - SPECIALTY PHARMACY
HM41653 UNIVERSITY OF KENTUCKY HEMOPHILIA TREATMENT CENTER
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Covered Entity Details
Entity Name
UNIVERSITY OF KENTUCKY HEMOPHILIA TREATMENT CENTER
Subdivision Name
Outreach Clinic Prestonsburg , KY
Type
Comprehensive Hemophilia Treatment Center
340B ID
HM41653
Entity Address
KY Commission for Children with Special Healthcare Needs / Highlands Regional Medical Center
5000 KY Route 321
Prestonsburg, KY 41653
Grant Number
H30MC24046
Participating Start Date
1/1/2018
Last Recertification Date
3/4/2025
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
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