340B Drug Pricing Program Database

Name

CAMDEN-ON-GAULEY MEDICAL CENTER, INC.

Subdivision Name

CENTERAL WV COMMUNITY HLTH CTR

Type

HRSA-Funded Health Center

Site ID

BPS-H80-000590

340B ID

CH03310A

Grant Number

H80CS00078

Current Program Status

Terminated

Registration Date

9/2/2005

Participating Start Date

9/9/2005

Participating Approval Date

9/2/2005

Last Recertification Date

2/5/2019

Termination Date
Termination Reason

1/1/2020
Business decision by the Covered Entity

Authorizing Official

Camden on Gauley Medical Center, Inc
Margaret Hickey, CEO
(304) 226-5725

Primary Contact

Camden on Gauley Medical Center, Inc.
Thomas Stark, Pharmacist
(304) 872-1663

Street Address

55 Friends R Fun Dr
Summersville, WV 26651-9514

Billing Address

CAMDEN ON GAULEY MEDICAL CENTER, INC.
10003 WEBSTER RD, PO BOX 69
CAMDEN ON GAULEY, WV 26208