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MADISON FAMILY PHARMACY, LLC
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
MADISON FAMILY PHARMACY, LLC
Pharmacy Address
313 MADISON AVENUE
MADISON, WV 25130-1510
Pharmacy Comments
Contract Details
Approval Date
4/19/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
5/10/2018
Pharmacy closed
Contacts
Covered Entity Signing Official
Martha Carter, CEO
(304) 760-6316
Contract Pharmacy Representative
Charles Burdette, Owner
(304) 369-0209
Signed By Date
4/19/2017
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