340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
CLENDENIN PHARMACY
DSH510029 Thomas Memorial Hospital
Print
Covered Entity Details
Entity Name
Thomas Memorial Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510029
Entity Address
4605 MacCorkle Avenue, SW
South Charleston, WV 25309
Medicare Provider Number
510029
Participating Start Date
7/1/2014
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
CLENDENIN PHARMACY
Pharmacy Address
10 MAIN STREET
PO BOX 698
CLENDENIN, WV 25045
Pharmacy Comments
Contract Details
Approval Date
1/17/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/19/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Brian L Ulery, Chief Operating Officer (COO)
(304) 766-3445
Contract Pharmacy Representative
Clendenin Pharmacy
Lindsay Matuszkiewicz, Pharmacy Manager
(304) 548-5451
Signed By Date
1/17/2019
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session