Covered Entity Details

CH03421AS COMMUNITY CARE OF WEST VIRGINIA, INC. (Active) - information as of 6/27/2025 12:34:05 AM

Main Details

Name

COMMUNITY CARE OF WEST VIRGINIA, INC.

Subdivision Name

Robert Bland Middle School Wellness Center

Type

HRSA-Funded Health Center

Site ID

BPS-H80-016816

340B ID

CH03421AS

Grant Number

H80CS00080

Additional Details

Current Program Status

Active

Registration Date

1/6/2016

Participating Start Date

4/1/2016

Participating Approval Date

2/12/2016

Last Recertification Date

2/17/2025

Contacts

Authorizing Official

Community Care of West Virginia
Patricia Collett, Chief Executive Officer
(304) 473-5560

Primary Contact

Community Care of West Virginia
Joshua Dunn, Pharmacist
(304) 473-2291

Addresses

Street Address

358 Court Ave.
Weston, WV 26452-2008

Billing Address

Community Care of West Virginia
78 QUEENS ALLEY RD
PO BOX 217
ROCK CAVE, WV 26234

Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
History

Comments

Comment	Last Updated On
No records to display.

Medicaid Billing

At this site, will the covered entity bill Medicaid fee-for-service for drugs purchased at 340B prices?
No

Shipping Addresses

Same as Street Address

Contract Pharmacies

Contract Detail	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Approval Date	Begin Date	Carve-In Effective Date	Termination Date	Last Updated On
Contract Detail	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	02/12/2016	04/01/2016		10/06/2016	10/11/2016
Contract Detail	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	02/12/2016	04/01/2016		10/06/2016	10/11/2016

Grantee Sites

340B ID	340B Status	SiteId	Name	Sub Name	Address	City	State
CH034090	Active	BPS-H80-010380	Community Care of West Virginia, Inc.	Community Care of Clay	122 Center St	Clay	WV
CH03409A	Active	BPS-H80-010382	Community Care of West Virginia, Inc.	Community Care of Big Otter	797 Clinic Dr	Ivydale	WV
CH03409B	Active	BPS-H80-010384	Community Care of West Virginia, Inc.	Clay High School Wellness Center	1 Panther Drive	Clay	WV
CH03409C	Active	BPS-H80-010381	Community Care of West Virginia, Inc.	Clay Elementary School Wellness Center	168 Church St	Clay	WV
CH03409D	Active	BPS-H80-010379	Community Care of West Virginia, Inc.	Clay Middle School Wellness Center	236 Church St	Clay	WV
CH03409E	Active	BPS-H80-010383	Community Care of West Virginia, Inc.	Big Otter Elementary Wellness Center	59 Ossia Rd	Duck	WV
CH034210	Active	BPS-H80-001476	Community Care of West Virginia, Inc.	Community Care of Rock Cave	78 Queens Alley Rd	ROCK CAVE	WV
CH03421AA	Active	BPS-H80-012035	Community Care of West Virginia, Inc.	West Milford Elementary School Wellness Center	226 School St	West Milford	WV
CH03421AB	Active	BPS-H80-013488	Community Care of West Virginia, Inc.	Davis Elementary School Wellness Center	113 5th St	Gassaway	WV
CH03421AC	Active	BPS-H80-013486	Community Care of West Virginia, Inc.	Frametown Elementary School Wellness Center	HC 61 Box 14	Frametown	WV
CH03421AD	Active	BPS-H80-013442	Community Care of West Virginia, Inc.	Marlinton Middle School Wellness Center	Route 2 Box 525	Buckeye	WV
CH03421AE	Active	BPS-H80-011882	Community Care of West Virginia, Inc.	Pocahontas County High School Wellness Center	271 Warrior Way	Dunmore	WV
CH03421AF	Active	BPS-H80-011880	Community Care of West Virginia, Inc.	Marlinton Elementary School Wellness Center	926A 5th Ave	Marlinton	WV
CH03421AG	Active	BPS-H80-011878	Community Care of West Virginia, Inc.	Green Bank Elementary-Middle School Wellness Center	5917 Potomac Highlands Trl	Green Bank	WV
CH03421AH	Active	BPS-H80-012996	Community Care of West Virginia, Inc.	Buckhannon-Upshur Middle School Wellness Center	Rt 6 Box 303	Buckhannon	WV
CH03421AJ	Active	BPS-H80-012030	Community Care of West Virginia, Inc.	Buckhannon-Upshur High School Wellness Center	50 B U Dr	Buckhannon	WV
CH03421AK	Active	BPS-H80-011460	Community Care of West Virginia, Inc.	Buckhannon Academy Elementary School Wellness Center	16 College Avenue	Buckhannon	WV
CH03421AL	Active	BPS-H80-011459	Community Care of West Virginia, Inc.	French Creek Elementary School Wellness Center	Rt 2 Box 305	French Creek	WV
CH03421AM	Active	BPS-H80-014807	COMMUNITY CARE OF WEST VIRGINIA, INC.	Bridgeport High School Wellness Center	515 JOHNSON AVE	BRIDGEPORT	WV
CH03421AN	Active	BPS-H80-015784	COMMUNITY CARE OF WEST VIRGINIA, INC.	Simpson Elementary School Wellness Center	250 Worthington Dr	Bridgeport	WV
CH03421AP	Active	BPS-H80-014830	COMMUNITY CARE OF WEST VIRGINIA, INC.	Mountaineer Middle School Wellness Center	2 MOUNTAINEER DR	CLARKSBURG	WV
CH03421AQ	Active	BPS-H80-015589	COMMUNITY CARE OF WEST VIRGINIA, INC.	Roanoke Elementary School Wellness Center	1176 Oil Creek Rd.	Roanoke	WV
CH03421AR	Active	BPS-H80-015590	COMMUNITY CARE OF WEST VIRGINIA, INC.	Peterson-Central Elementary School Wellness Center	509 Berlin Road	Weston	WV
CH03421AS	Active	BPS-H80-016816	COMMUNITY CARE OF WEST VIRGINIA, INC.	Robert Bland Middle School Wellness Center	358 Court Ave.	Weston	WV
CH03421AT	Active	BPS-H80-016844	COMMUNITY CARE OF WEST VIRGINIA, INC.	Jane Lew Elementary School Wellness Center	6536 Main Street	Jane Lew	WV
CH03421AU	Terminated	BPS-H80-017044	COMMUNITY CARE OF WEST VIRGINIA, INC.	HE White Elementary School Wellness Center	501 Bomont Rd.	Bomont	WV
CH03421AV	Terminated	BPS-H80-016814	COMMUNITY CARE OF WEST VIRGINIA, INC.	Lizemore Elementary School Wellness Center	100 Lizemore Lions Rd	Lizemores	WV
CH03421AW	Active	BPS-H80-014813	COMMUNITY CARE OF WEST VIRGINIA, INC.	North View Elementary School Wellness Center	1400 N 19TH ST	CLARKSBURG	WV
CH03421AX	Active	BPS-H80-014812	COMMUNITY CARE OF WEST VIRGINIA, INC.	Liberty High School Wellness Center	1 MOUNTAINEER DR	CLARKSBURG	WV
CH03421AY	Terminated	BPS-H80-014811	COMMUNITY CARE OF WEST VIRGINIA, INC.	Johnson Elementary School Wellness Center	531 JOHNSON AVE	BRIDGEPORT	WV
CH03421AZ	Active	BPS-H80-014809	COMMUNITY CARE OF WEST VIRGINIA, INC.	Adamston Elementary School Wellness Center	1636 W PIKE ST	CLARKSBURG	WV
CH03421B	Active	BPS-H80-003558	Community Care of West Virginia, Inc.	Community Care of Helvetia	PICKENS ROAD	HELVETIA	WV
CH03421BA	Active	BPS-H80-014808	COMMUNITY CARE OF WEST VIRGINIA, INC.	Norwood Elementary School Wellness Center	208 KIDD AVE	STONEWOOD	WV
CH03421BB	Active	BPS-H80-014806	COMMUNITY CARE OF WEST VIRGINIA, INC.	Alternative Learning Center Wellness Center	1040 WILSONBURG RD	CLARKSBURG	WV
CH03421BC	Active	BPS-H80-014664	COMMUNITY CARE OF WEST VIRGINIA, INC.	Salem Elementary School Wellness Center	273 Education Way	SALEM	WV
CH03421BD	Terminated	BPS-H80-014105	COMMUNITY CARE OF WEST VIRGINIA, INC.	Community Care of Hillsboro	7576 Seneca Trail	Hillsboro	WV
CH03421BE	Active	BPS-H80-014810	COMMUNITY CARE OF WEST VIRGINIA, INC.	Bridgeport Middle School Wellness Center	413 JOHNSON AVE	BRIDGEPORT	WV
CH03421BF	Active	BPS-H80-017466	COMMUNITY CARE OF WEST VIRGINIA, INC.	Community Care of Flatwoods II	273 Skidmore Lane	Sutton	WV
CH03421BG	Active	BPS-H80-015442	COMMUNITY CARE OF WEST VIRGINIA, INC.	Community Care of Bridgeport	65 Professional Place	Bridgeport	WV
CH03421BH	Active	BPS-H80-017090	COMMUNITY CARE OF WEST VIRGINIA, INC.	Community Care of Buckhannon	35-37 Main Street	Buckhannon	WV
CH03421BJ	Active	BPS-H80-018563	COMMUNITY CARE OF WEST VIRGINIA, INC.	United Technical Center Wellness Center	251 Marietta St.	Clarksburg	WV
CH03421BK	Active	BPS-H80-018564	COMMUNITY CARE OF WEST VIRGINIA, INC.	Victory Elementary School Wellness Center	1349 Shinnston Pike	Clarksburg	WV
CH03421BL	Active	BPS-H80-021141	Community Care of West Virginia, Inc.	Leading Creek Elementary School Wellness Center	15300 US Highway 33 W	Linn	WV
CH03421BM	Active	BPS-H80-021197	Community Care of West Virginia, Inc.	Burnsville Elementary School Wellness Center	228 Kanawha Ave	Burnsville	WV
CH03421BN	Active	BPS-H80-021196	Community Care of West Virginia, Inc.	Flatwoods Elementary School Wellness Center	142 Flatwoods Corner Rd.	Flatwoods	WV
CH03421BP	Active	BPS-H80-021269	Community Care of West Virginia, Inc.	Sutton Elementary School Wellness Center	288 N Hill Rd	Sutton	WV
CH03421BQ	Active	BPS-H80-021198	Community Care of West Virginia, Inc.	Little Birch Elementary School Wellness Center	55 Little Birch Rd	Sutton	WV
CH03421BR	Active	BPS-H80-022043	Community Care of West Virginia, Inc.	Community Care of Weston	107 Staunton Dr.	Weston	WV
CH03421BS	Active	BPS-H80-022134	Community Care of West Virginia, Inc.	West Virginia Wesleyan College Wellness Center	59 College Ave.	Buckhannon	WV
CH03421BT	Active	BPS-H80-024393	Community Care of West Virginia, Inc.	Johnson Elementary School Wellness Center	601 Johnson Avenue	Bridgeport	WV
CH03421BU	Active	BPS-H80-027937	Community Care of West Virginia, Inc.	Washington District Elementary School Wellness Center	5078 Tallmansville Rd	Buckhannon	WV
CH03421BV	Active	BPS-H80-027938	Community Care of West Virginia, Inc.	Union Elementary School Wellness Center	481 Heavner Grove Rd	Buckhannon	WV
CH03421BW	Active	BPS-H80-030348	Community Care of West Virginia, Inc.	Community Care Connections of Buckhannon	34 N Kanawha St	Buckhannon	WV
CH03421BX	Active	BPS-H80-031086	Community Care of West Virginia, Inc.	Upshur County PALS Wellness Center	33 E Victoria St	Buckhannon	WV
CH03421BY	Active	BPS-H80-032952	Community Care of West Virginia, Inc.	Davis and Elkins College Wellness Center	70 Graceland Dr Rm 206	Elkins	WV
CH03421BZ	Active	BPS-H80-033471	COMMUNITY CARE OF WEST VIRGINIA, INC.	CareXpress of Buckhannon	77 W Main St	Buckhannon	WV
CH03421C	Active	BPS-H80-003672	Community Care of West Virginia, Inc.	Community Care of West Milford	597 LIBERTY ST	WEST MILFORD	WV
CH03421CA	Active	BPS-H80-036066	COMMUNITY CARE OF WEST VIRGINIA, INC.	Genesis Youth Crisis Wellness Center	591 Kappa Sigma Pi Dr.	Clarksburg	WV
CH03421CB	Active	BPS-H80-036049	COMMUNITY CARE OF WEST VIRGINIA, INC.	Community Care Connections of Weston	133 Staunton Drive	Weston	WV
CH03421CC	Active	BPS-H80-036893	COMMUNITY CARE OF WEST VIRGINIA, INC.	Community Care Connections of Flatwoods	235 Skidmore Lane	Sutton	WV
CH03421CD	Active	BPS-H80-038369	COMMUNITY CARE OF WEST VIRGINIA, INC.	Community Care of Bridgeport	100 Market Pl	Bridgeport	WV
CH03421CE	Active	BPS-H80-039298	COMMUNITY CARE OF WEST VIRGINIA, INC.	Rock Cave Elementary School Wellness Center	12292 WV-20	Rock Cave	WV
CH03421CF	Approved	BPS-H80-039325	COMMUNITY CARE OF WEST VIRGINIA, INC.	Tennerton Elementary School Wellness Center	167 Gawthrop Rd	Buckhannon	WV
CH03421D	Active	BPS-H80-018933	Community Care of West Virginia, Inc.	Community Care Pediatrics of Buckhannon	4 North Ridge Dr., Suite 118	Buckhannon	WV
CH03421E	Terminated	BPS-H80-000044	Community Care of West Virginia, Inc.	Braxton Healthcare Associates	617 River Street	Gassaway	WV
CH03421F	Active	BPS-H80-011082	Community Care of West Virginia, Inc.	Community Care of Marlinton	821 3rd Ave	Marlinton	WV
CH03421G	Active	BPS-H80-008842	Community Care of West Virginia, Inc.	Community Care of Green Bank	4498 Potomac Highlands Trl	Green Bank	WV
CH03421H	Active	BPS-H80-012852	Community Care of West Virginia, Inc.	Community Care of Flatwoods	266 SKIDMORE LN	SUTTON	WV
CH03421J	Active	BPS-H80-013061	Community Care of West Virginia, Inc.	Carexpress of Weston	149 Staunton Drive	Weston	WV
CH03421K	Active	BPS-H80-013487	Community Care of West Virginia, Inc.	Community Care of Clarksburg	700 OAKMOUND RD	CLARKSBURG	WV
CH03421L	Active	BPS-H80-011879	Community Care of West Virginia, Inc.	Community Dental Care of Green Bank	6404 Potomac Highlands Trail	Green Bank	WV
CH03421M	Active	BPS-H80-012885	Community Care of West Virginia, Inc.	Washington Irving Middle School Wellness Center	443 Lee Ave	Clarksburg	WV
CH03421N	Active	BPS-H80-012886	Community Care of West Virginia, Inc.	Robert C Byrd High School Wellness Center	1 Eagle Way	Clarksburg	WV
CH03421P	Active	BPS-H80-012891	Community Care of West Virginia, Inc.	Lumberport Elementary School Wellness Center	38 E Lyndon St.	Lumberport	WV
CH03421Q	Terminated	BPS-H80-012890	Community Care of West Virginia, Inc.	Lumberport Middle School Wellness Center	Rt 1 Box 2	Lumberport	WV
CH03421R	Active	BPS-H80-017670	Community Care of West Virginia, Inc.	Lincoln Middle and High School Wellness Center	78 Jerry Toth Drive	Shinnston	WV
CH03421S	Active	BPS-H80-012894	Community Care of West Virginia, Inc.	Big Elm Elementary School Wellness Center	200 Tetrick Rd	Shinnston	WV
CH03421T	Active	BPS-H80-012892	Community Care of West Virginia, Inc.	Nutter Fort Intermediate School Wellness Center	1302 Buckhannon Pike	Nutter Fort	WV
CH03421U	Active	BPS-H80-012887	Community Care of West Virginia, Inc.	Nutter Fort Primary School Wellness Center	1302 Buckhannon Pike	Nutter Fort	WV
CH03421V	Active	BPS-H80-012031	Community Care of West Virginia, Inc.	South Harrison Middle School Wellness Center	3003 Hawk Hwy	Lost Creek	WV
CH03421W	Active	BPS-H80-012028	Community Care of West Virginia, Inc.	South Harrison High School Wellness Center	3073 Hawk Hwy	Lost Creek	WV
CH03421X	Active	BPS-H80-012033	Community Care of West Virginia, Inc.	Lost Creek Elementary School Wellness Center	128 College Street	Lost Creek	WV
CH03421Y	Active	BPS-H80-012029	Community Care of West Virginia, Inc.	Braxton County High School Wellness Center	200 Jerry Burton Dr	Sutton	WV
CH03421Z	Active	BPS-H80-012034	Community Care of West Virginia, Inc.	Braxton County Middle School Wellness Center	100 Carter Braxton Dr	Sutton	WV

Grantee Sites Contract Pharmacies

340B ID	Pharmacy Name	Address	Address Cont.	City	State	Zip Code	Begin Date	Termination Date
CH03421C	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	10/01/2014	12/16/2020
CH03421F	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	11/15/2010	12/16/2020
CH03421G	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	10/01/2014	12/16/2020
CH03421L	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	10/01/2014	12/16/2020
CH03421AG	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	10/01/2014	12/16/2020
CH03421AF	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	10/01/2014	12/16/2020
CH03421AE	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	10/01/2014	12/16/2020
CH03421AD	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	10/01/2014	12/16/2020
CH03421BD	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	01/01/2017	01/01/2019
CH03421BG	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	07/01/2016	12/16/2020
CH034210	BATJAC OF SOUTH CAROLINA	DBA POCAHONTAS PHARMACY	P.O. BOX 148 105 DUNCAN RD	MARLINTON	WV	24954	07/01/2020	12/16/2020
CH03409A	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	10/01/2014	12/16/2020
CH03421C	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	10/01/2014	12/16/2020
CH03421E	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	05/01/2010	01/01/2017
CH03409E	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	10/01/2014	12/16/2020
CH03421H	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	10/01/2014	12/16/2020
CH03421AC	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	10/01/2014	12/16/2020
CH03421AB	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	10/01/2014	12/16/2020
CH03421Z	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	10/01/2014	12/16/2020
CH03421Y	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	10/01/2014	12/16/2020
CH03421BG	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	07/01/2016	12/16/2020
CH03421BF	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	07/01/2016	12/16/2020
CH034210	CARL WALKER'S DRUG STORE	620 ELK ST		GASSAWAY	WV	26624	07/01/2020	12/16/2020
CH034210	CLAY FAMILY PHARMACY	2000 MAIN ST		CLAY	WV	25043	07/01/2019
CH03421BE	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	09/30/2020
CH03421BC	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	10/06/2016
CH03421BB	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	10/10/2016
CH03421AM	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	09/30/2020
CH03421BA	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	09/30/2020
CH03421AZ	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	09/30/2020
CH03421AY	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	04/01/2020
CH03421AX	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	09/30/2020
CH03421AW	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	09/30/2020
CH03421AT	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	09/30/2020
CH03421AS	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	10/06/2016
CH03421AN	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	10/07/2016
CH03421AR	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	09/30/2020
CH03421AP	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	04/01/2016	09/30/2020
CH03421BG	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	07/01/2016	09/30/2020
CH03421BF	COMMUNITY CARE OF WEST VIRGINIA	DBA COMMUNITY CARE PHARMACY OF WESTON	107 STAUNTON DR	WESTON	WV	26452	07/01/2016	09/30/2020
CH034210	CURANT HEALTH FLORIDA, LLC	11001 ROOSEVELT BLVD N STE 1400		ST PETERSBURG	FL	33716	07/01/2023
CH034210	CURANT HEALTH GEORGIA LLC	CURANT HEALTH	200 TECHNOLOGY CT SE BLDG 200 SUITE B	SMYRNA	GA	30082-5250	07/01/2023
CH034210	GIL-CO FAITH PHARMACY	GIL-CO FAITH PHARMACY	356 WV HIGHWAY 5 E	GLENVILLE	WV	26351	07/01/2025
CH034210	KROGER COLUMBUS CENTRAL FILL #019	2270 RICKENBACKER PKWY W		COLUMBUS	OH	43217	07/01/2024
CH034210	KROGER PHARMACY #688	788 WEST PIKE STREET		CLARKSBURG	WV	26301	01/01/2020	01/19/2021
CH034210	KROGER PHARMACY #722	80 SKYLINE PLAZA DR		BUCKHANNON	WV	26201	01/01/2020
CH034210	KROGER PHARMACY #730	450-11TH ST		ELKINS	WV	26241	01/01/2020
CH034210	KROGER PHARMACY #774	102 EMILY DR		CLARKSBURG	WV	26301-5501	01/01/2020
CH03421C	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	10/01/2014	09/29/2022
CH03421F	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	10/01/2014	09/29/2022
CH03421G	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	08/20/2012	09/29/2022
CH03421L	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	10/01/2014	09/29/2022
CH03421AG	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	10/01/2014	09/29/2022
CH03421AF	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	10/01/2014	09/29/2022
CH03421AE	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	10/01/2014	09/29/2022
CH03421AD	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	10/01/2014	09/29/2022
CH03421BD	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	01/01/2017	01/01/2019
CH03421BG	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	07/01/2016	09/29/2022
CH034210	MORGANTOWN DRUG COMPANY, LLC.	DBA GREENBANK PHARMACY	P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA	GREEN BANK	WV	24944	07/01/2020	09/29/2022
CH034210	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	10/07/2016
CH034090	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	08/01/2009	10/06/2016
CH03409D	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	08/01/2009	10/10/2016
CH03409B	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	08/01/2009	10/10/2016
CH03409A	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	08/01/2009	09/30/2020
CH03409C	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	08/01/2009	10/10/2016
CH03421B	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	10/10/2016
CH03421C	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	10/07/2016
CH03421D	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	09/30/2020
CH03421E	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	01/01/2017
CH03421H	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	07/01/2014	09/30/2020
CH03421J	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	10/10/2016
CH03421K	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	09/30/2020
CH03421L	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	09/30/2020
CH03421AL	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	09/30/2020
CH03421AC	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	09/30/2020
CH03421AB	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	09/30/2020
CH03421Z	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	09/30/2020
CH03421Y	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	10/01/2014	09/30/2020
CH03421AU	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	04/01/2016	10/10/2016
CH03421BG	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	07/01/2016	09/30/2020
CH03421BF	TRI-COUNTY HEALTH CLINIC INC DBA PRIMARY	122 CENTER STREET	PO BOX 939	CLAY	WV	25043	07/01/2016	09/30/2020
CH034090	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/06/2016
CH03409D	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/10/2016
CH03409B	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/10/2016
CH03409A	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03409C	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/10/2016
CH03421C	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	12/16/2008	10/07/2016
CH03421D	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/08/2008	09/30/2020
CH03421E	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	09/01/2010	01/01/2017
CH03421F	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	09/01/2010	09/30/2020
CH03409E	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421G	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	08/20/2012	09/30/2020
CH03421H	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	07/01/2014	09/30/2020
CH03421J	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	07/01/2014	10/10/2016
CH03421K	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	07/01/2014	09/30/2020
CH03421L	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AL	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AK	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AJ	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AH	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AG	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AF	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AE	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/06/2016
CH03421AD	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AC	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AB	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421AA	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/10/2016
CH03421Z	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421Y	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421X	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421W	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/07/2016
CH03421V	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/07/2016
CH03421U	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421T	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421S	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421R	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/10/2016
CH03421Q	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	01/01/2017
CH03421P	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	09/30/2020
CH03421N	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/06/2016
CH03421M	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	10/01/2014	10/07/2016
CH03421BE	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	09/30/2020
CH03421BD	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	01/01/2019
CH03421BC	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	10/06/2016
CH03421BB	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	10/10/2016
CH03421AM	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	09/30/2020
CH03421BA	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	09/30/2020
CH03421AZ	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	09/30/2020
CH03421AY	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	04/01/2020
CH03421AX	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	09/30/2020
CH03421AW	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	09/30/2020
CH03421AU	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	10/10/2016
CH03421AT	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	09/30/2020
CH03421AS	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	10/06/2016
CH03421AN	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	10/07/2016
CH03421AR	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	09/30/2020
CH03421AQ	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	10/06/2016
CH03421AP	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	04/01/2016	09/30/2020
CH03421BG	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	07/01/2016	09/30/2020
CH03421BF	TRI-COUNTY PHARMACY	COMMNITY CARE OF WEST VIRGINIA	123 QUEENS ALLEY RD PO BOX 217	ROCK CAVE	WV	26234	07/01/2016	09/30/2020
CH034210	WAL-MART CENTRAL FILL 10-2670	608 SPRING HILL DR # 3 SUITE 300		SPRING	TX	77386	04/01/2020
CH034210	WAL-MART PHARMACY 10-1477	200 WAL STREET		SUMMERSVILLE	WV	26651	07/01/2025
CH034210	WAL-MART PHARMACY 10-1499	1976 JEFFERSON STREET NORTH		LEWISBURG	WV	24901	04/01/2019	04/15/2025
CH034090	WAL-MART PHARMACY 10-1544	550 EMILY DRIVE		CLARKSBURG	WV	26301	01/01/2019	10/15/2018
CH034210	WAL-MART PHARMACY 10-1544	550 EMILY DRIVE		CLARKSBURG	WV	26301	01/01/2019
CH034090	WAL-MART PHARMACY 10-1653	110 BERLIN ROAD		WESTON	WV	26452	01/01/2019	10/15/2018
CH034210	WAL-MART PHARMACY 10-1653	110 BERLIN ROAD		WESTON	WV	26452	01/01/2019
CH034210	WAL-MART PHARMACY 10-2809	100 BUCKHANNON CROSSROADS		BUCKHANNON	WV	26201	01/01/2019
CH034090	WAL-MART PHARMACY 10-2809	100 BUCKHANNON CROSSROADS		BUCKHANNON	WV	26201	01/01/2019	10/15/2018
CH034210	WAL-MART PHARMACY 10-2810	97 WILLIAMS DRIVE		SPENCER	WV	25276	07/01/2025
CH034210	WAL-MART PHARMACY 10-5997	9600 PARKSOUTH CT. SUITE 100		ORLANDO	FL	32837	04/01/2020
CH034210	WALGREEN CO.	DBA: WALGREENS #12276	1240 W. MAIN ST.	BRIDGEPORT	WV	26330	07/01/2025
CH034210	WALGREEN CO.	WALGREENS #19094	208 S PIKE ST.	SHINNSTON	WV	26431-1122	07/01/2025
CH034210	WALGREEN CO.	DBA: WALGREENS #12277	38 VICTORY AVE.	GRAFTON	WV	26354	07/01/2025
CH034210	Walgreens #21423	Walgreens Central Fill #21423	6275 Winchester Blvd	Canal WInchester	OH	43110-6537	07/01/2025
CH034210	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	04/01/2023	10/16/2023
CH034210	WALMART PHARMACY 10-5169	2252 NORTH 8TH STREET	SUITE A	ROGERS	AR	72756	07/01/2025
CH034090	WALMART PHARMACY 10-6951	369 SCOTTS FORK-BONNIE RD		SUTTON	WV	26601	01/01/2019	10/15/2018
CH034210	WALMART PHARMACY 10-6951	369 SCOTTS FORK-BONNIE RD		SUTTON	WV	26601	01/01/2019
CH034210	Walmart Pharmacy 10-7611	2501 Perry Rd		Plainfield	IN	46168	01/01/2024
CH034210	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 03186	701 E. MAIN STREET	CLARKSBURG	WV	26301	07/01/2025
CH034210	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04167	700 NORTHSIDE DR.	SUMMERSVILLE	WV	26651	07/01/2025
CH034210	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 04432	300 FOURTH AVE	MONTGOMERY	WV	25136	07/01/2025
CH034210	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05947	250 COURT STREET	WESTON	WV	26452	07/01/2025
CH034210	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 05957	221 CROSSINGS MALL ROAD	ELKVIEW	WV	25071	07/01/2025
CH034210	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 06307	2907 STATE STREET	GASSAWAY	WV	26624	07/01/2025
CH034210	WEST VIRGINIA CVS PHARMACY, L.L.C.	DBA: CVS/PHARMACY # 07649	74 WEST MAIN ST.	BUCKHANNON	WV	26201	07/01/2025

History

Section	Field	Action	Activity	Value Before	Value After	Timestamp
Details	Last Recertification Date	Update	Recertification	2/2/2024 12:34:51 PM	2/17/2025 12:06:09 PM	2/17/2025 12:06 PM
Addresses	Billing Address	Update	Recertification	TRI-COUNTY HEALTH CLINIC 78 QUEENS ALLEY RD PO BOX 217 ROCK CAVE, WV 26234	Community Care of West Virginia 78 QUEENS ALLEY RD PO BOX 217 ROCK CAVE, WV 26234	2/2/2024 12:34 PM
Details	Last Recertification Date	Update	Recertification	2/7/2023 3:23:07 PM	2/2/2024 12:34:51 PM	2/2/2024 12:34 PM
Contacts	Authorizing Official	Update	Group Change Request	Simon, Richard G CEO Community Care of West Virginia 3049246262	Collett, Patricia Chief Executive Officer Community Care of West Virginia 3044735560	10/17/2023 3:55 PM
Details	Last Recertification Date	Update	Recertification	2/4/2022 12:29:21 PM	2/7/2023 3:23:07 PM	2/7/2023 3:23 PM
Details	Last Recertification Date	Update	Recertification	2/18/2021 10:30:34 AM	2/4/2022 12:29:21 PM	2/4/2022 12:29 PM
Details	Last Recertification Date	Update	Recertification	1/29/2020 2:16:36 PM	2/18/2021 10:30:34 AM	2/18/2021 10:30 AM
Details	Last Recertification Date	Update	Recertification	2/14/2019 12:18:14 PM	1/29/2020 2:16:36 PM	1/29/2020 2:16 PM
Contacts	Signed By	Update	Change Request	Simon, Rick G. CEO Community Care of West Virginia 3049246262	Simon, Richard G. CEO Community Care of West Virginia 3049246262	5/23/2019 12:45 PM
Details	Last Recertification Date	Update	Recertification	2/14/2018 9:41:38 AM	2/14/2019 12:18:14 PM	2/14/2019 12:18 PM
Details	Last Recertification Date	Update	Recertification	2/7/2017 12:00:00 AM	2/14/2018 9:41:38 AM	2/14/2018 9:41 AM
Contacts	Primary Contact	Update	Change Request	Hamner, Christine Pharmacist 3049246784-1089	Dunn, Joshua Pharmacist Community Care of West Virginia 3044732291	1/17/2018 8:26 AM
Details	Is Authorizing Official EHB Data	Update	Change Request	False		1/17/2018 8:26 AM
Contacts	Authorizing Official	Insert	AO Change Request		Simon, Richard G CEO Community Care of West Virginia 3049246262	11/7/2017 9:28 AM
Contacts	Signed By	Update		Simon, Rick G. CEO 3049246262	Simon, Rick G. CEO Community Care of West Virginia 3049246262	10/16/2017 9:39 AM
Contacts	Signed By	Insert			Simon, Rick G. CEO 3049246262	4/18/2017 4:43 PM
Contacts	Primary Contact	Insert			Hamner, Christine Pharmacist 3049246784-1089	4/18/2017 4:43 PM
Addresses	Main Address	Insert			358 Court Ave. Weston, WV 26452-2008	2/7/2017 1:44 PM
Details	Last Recertification Date	Update			2/7/2017 12:00:00 AM	2/7/2017 1:44 PM
Addresses	Billing Address	Insert			TRI-COUNTY HEALTH CLINIC 78 QUEENS ALLEY RD PO BOX 217 ROCK CAVE, WV 26234	10/12/2016 9:30 AM
Dates	Participating Approval Date	Update			2/12/2016 12:00:00 AM	2/12/2016 11:41 AM
Details	State	Update		Pending	Active	2/12/2016 11:41 AM
Dates	Start Date	Update			4/1/2016 12:00:00 AM	2/12/2016 11:41 AM
Details	340B ID	Update		ONLINE_REG_56661	CH03421AS	2/12/2016 11:08 AM
Details	340B ID	Update		ONLINE_REG	ONLINE_REG_56661	1/6/2016 10:34 AM
Details	Last Recertification Date	Insert				1/6/2016 10:34 AM
Details	Grant Number	Insert			H80CS00080	1/6/2016 10:34 AM
Details	340B ID	Insert			ONLINE_REG	1/6/2016 10:34 AM
Details	Is Authorizing Official EHB Data	Insert			False	1/6/2016 10:34 AM
Dates	Last Date That 340B Drugs Purchased	Insert				1/6/2016 10:34 AM
Details	Medicare Provider Number	Insert				1/6/2016 10:34 AM
Details	Entity Name	Insert			COMMUNITY CARE OF WEST VIRGINIA, INC.	1/6/2016 10:34 AM
Details	Program Code	Insert			CH	1/6/2016 10:34 AM
Details	Entity Subname	Insert			Robert Bland Middle School Wellness Center	1/6/2016 10:34 AM
Dates	Participating Approval Date	Insert				1/6/2016 10:34 AM
Details	State	Insert			Pending	1/6/2016 10:34 AM
Dates	Registration Date	Insert			1/6/2016 12:00:00 AM	1/6/2016 10:34 AM
Dates	Signed By Date	Insert			1/6/2016 12:00:00 AM	1/6/2016 10:34 AM
Dates	Start Date	Insert				1/6/2016 10:34 AM
Terminations	Termination Comments	Insert				1/6/2016 10:34 AM
Terminations	Termination Date	Insert				1/6/2016 10:34 AM
Terminations	Termination Effective Date	Insert				1/6/2016 10:34 AM
Terminations	Termination Reason	Insert				1/6/2016 10:34 AM

340B Drug Pricing Program Database