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WAL-MART PHARMACY 10-1351
CAH511310-00 APPALACHIAN REGIONAL HEALTHCARE INC. D/B/A SUMMERS CO ARH HOSPITAL
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Covered Entity Details
Entity Name
APPALACHIAN REGIONAL HEALTHCARE INC. D/B/A SUMMERS CO ARH HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH511310-00
Entity Address
115 SUMMERS HOSPITAL ROAD
HINTON, WV 25951
Medicare Provider Number
511310
Participating Start Date
9/8/2010
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-1351
Pharmacy Address
1330 N EISENHOWER DR
BECKLEY, WV 25801
Pharmacy Comments
Contract Details
Approval Date
7/12/2019
Contract Begin Date
10/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
1/10/2020
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Contract Pharmacy Representative
Walmart
Julie Howard, Senior Manager, 340B Program
(479) 277-1498
Signed By Date
7/12/2019
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