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CROSS LANES FAMILY PHARMACY
CH038440 WOMENCARE, INC.
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Covered Entity Details
Entity Name
WOMENCARE, INC.
Subdivision Name
FamilyCare Health Center - Teays Valley
Type
HRSA-Funded Health Center
340B ID
CH038440
Entity Address
97 Great Teays Blvd STE 6
Scott Depot, WV 25560-9816
Grant Number
H80CS00827
Participating Start Date
7/1/2000
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
CROSS LANES FAMILY PHARMACY
Pharmacy Address
107 GOFF MOUNTAIN RD
CROSS LANES, WV 25313
Pharmacy Comments
Contract Details
Approval Date
7/16/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/11/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Martha Carter, CEO
(304) 760-6316
Contract Pharmacy Representative
Cross Lanes Family Pharmacy
Brac Brown, Owner
(304) 204-2588
Signed By Date
7/16/2018
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