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| Contacts | Signed By | Insert | New Registration | | Yokum, Amy C.
CEO
Ritchie County Primary Care Association, Inc.
3046434005-3046131904 | 5/7/2025 6:09 AM |
| Details | 340B ID | Update | New Registration | | CH03792J | 5/7/2025 6:09 AM |
| Dates | Participating Approval Date | Update | New Registration | | 5/7/2025 6:09:25 AM | 5/7/2025 6:09 AM |
| Details | State | Update | New Registration | Pending | Approved | 5/7/2025 6:09 AM |
| Dates | Signed By Date | Update | New Registration | | 4/11/2025 2:25:11 PM | 5/7/2025 6:09 AM |
| Dates | Start Date | Update | New Registration | | 7/1/2025 12:00:00 AM | 5/7/2025 6:09 AM |
| Addresses | Main Address | Insert | New Registration | |
111 Lafayette St, Ste 201
Saint Marys, WV 26170-1059 | 4/11/2025 2:01 PM |
| Contacts | Authorizing Official | Insert | New Registration | | Yokum, Amy C.
CEO
Ritchie County Primary Care Association, Inc.
3046434005-3046131904 | 4/11/2025 2:01 PM |
| Contacts | Primary Contact | Insert | New Registration | | Shipe, Devan
Human Resources Assistant
Ritchie County Primary Care Association
3046434005 | 4/11/2025 2:01 PM |
| Details | Assistance Received From Date | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Details | Assistance Received To Date | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Details | Last Recertification Date | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Details | Grant Number | Insert | New Registration | | H80CS00843 | 4/11/2025 2:01 PM |
| Details | 340B ID | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Details | Is Authorizing Official EHB Data | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Dates | Last Date That 340B Drugs Purchased | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Details | Medicare Provider Number | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Details | Entity Name | Insert | New Registration | | RITCHIE COUNTY PRIMARY CARE ASSOCIATION | 4/11/2025 2:01 PM |
| Details | NOFO Number | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Details | Program Code | Insert | New Registration | | CH | 4/11/2025 2:01 PM |
| Details | Entity Subname | Insert | New Registration | | Integrated Health Centers of West Virginia-St. Marys | 4/11/2025 2:01 PM |
| Dates | Participating Approval Date | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Details | State | Insert | New Registration | | Pending | 4/11/2025 2:01 PM |
| Dates | Registration Date | Insert | New Registration | | 4/11/2025 2:01:50 PM | 4/11/2025 2:01 PM |
| Dates | Signed By Date | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Dates | Start Date | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Terminations | Termination Comments | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Terminations | Termination Date | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Terminations | Termination Effective Date | Insert | New Registration | | | 4/11/2025 2:01 PM |
| Terminations | Termination Reason | Insert | New Registration | | | 4/11/2025 2:01 PM |