340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
WAL-MART PHARMACY 10-5315
RRC510023-00 WEIRTON MEDICAL CENTER
Print
Covered Entity Details
Entity Name
WEIRTON MEDICAL CENTER
Subdivision Name
Type
Rural Referral Center
340B ID
RRC510023-00
Entity Address
601 COLLIERS WAY
WEIRTON, WV 26062
Medicare Provider Number
510023
Participating Start Date
1/1/2021
Last Recertification Date
8/31/2021
Entity Termination Date
1/1/2022
Pharmacy Details
Pharmacy Name
WAL-MART PHARMACY 10-5315
Pharmacy Address
2354 COMMERCE PARK DR.
ORLANDO, FL 32819
Pharmacy Comments
Contract Details
Approval Date
10/8/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
7/1/2020
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Eugene D Trout, CFO
(304) 797-6323
Contract Pharmacy Representative
Wal-mart
Laura Levine, Manager Contracting
(479) 204-8550
Signed By Date
10/8/2019
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