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CUSTOMSCRIPT INFUSION VITAL CARE
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
CUSTOMSCRIPT INFUSION VITAL CARE
Pharmacy Address
DBA CUSTOMSCRIPT INFUSION
3738 TEAYS VALLEY RD
SUITE B
HURRICANE, WV 25526
Pharmacy Comments
Contract Details
Approval Date
4/6/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/30/2016
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
STEVEN L. SHATTLS, CEO
(304) 525-3334 Ext: 5107
Contract Pharmacy Representative
Chad Wallace, Owner
(304) 543-3292
Signed By Date
4/6/2015
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