340B Drug Pricing Program Database
WALGREEN CO.
CH034210 Community Care of West Virginia, Inc. - information as of 4/29/2025 4:39:35 AM
Covered Entity Details
Entity Name
Community Care of West Virginia, Inc.
Subdivision Name
Community Care of Rock Cave
Type
HRSA-Funded Health Center
340B ID
CH034210
Entity Address
78 Queens Alley Rd
ROCK CAVE, WV 26234-0217
Grant Number
H80CS00080
Participating Start Date
4/1/2003
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #12276
1240 W. MAIN ST.
BRIDGEPORT, WV 26330
Pharmacy Comments
Contract Details
Approval Date
4/15/2025
Contract Begin Date
7/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Patricia Collett, Chief Executive Officer
(304) 473-5560
Contract Pharmacy Representative
Walgreens
Ruthann Archer, Director of 340B Operations
(847) 964-8116
Signed By Date
4/15/2025
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