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GREGGS PHARMACY INC
CAH511312-00 PRESTON MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
PRESTON MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH511312-00
Entity Address
150 MEMORIAL DRIVE
KINGWOOD, WV 26537-1495
Medicare Provider Number
511312
Participating Start Date
8/9/2010
Last Recertification Date
8/29/2024
Pharmacy Details
Pharmacy Name
GREGGS PHARMACY INC
Pharmacy Address
20 N 3RD ST
OAKLAND, MD 21550-1322
Pharmacy Comments
Contract Details
Approval Date
4/4/2019
Contract Begin Date
7/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/6/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
KEVIN GESSLER, Vice President Financial Services
(304) 329-1400 Ext: 1120
Contract Pharmacy Representative
Gregg's Pharmacy Inc.
Fred Gregg, Owner
(301) 334-2197
Signed By Date
4/4/2019
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