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WAL-MART PHARMACY 10-1478
CH030880 VALLEY HEALTH SYSTEMS, INC.
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Covered Entity Details
Entity Name
VALLEY HEALTH SYSTEMS, INC.
Subdivision Name
VALLEY HEALTH - EAST HUNTINGTON
Type
HRSA-Funded Health Center
340B ID
CH030880
Entity Address
85 Donohoe Dr
Huntington, WV 25705
Grant Number
H80CS00614
Participating Start Date
4/1/2000
Last Recertification Date
2/14/2025
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1478
Pharmacy Address
354 PRIVATE DRIVE 288
SOUTH POINT, OH 45680
Pharmacy Comments
Contract Details
Approval Date
10/2/2018
Contract Begin Date
1/1/2019
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
STEVEN L. SHATTLS, CEO
(304) 525-3334 Ext: 5107
Contract Pharmacy Representative
Wal-Mart
Jodi Prohofsky, Sr. Director, Payer Relations
(254) 301-6601
Signed By Date
10/2/2018
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