340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KROGER PHARMACY #774
CH034210 Community Care of West Virginia, Inc.
Print
Covered Entity Details
Entity Name
Community Care of West Virginia, Inc.
Subdivision Name
Community Care of Rock Cave
Type
HRSA-Funded Health Center
340B ID
CH034210
Entity Address
78 Queens Alley Rd
ROCK CAVE, WV 26234-0217
Grant Number
H80CS00080
Participating Start Date
4/1/2003
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #774
Pharmacy Address
102 EMILY DR
CLARKSBURG, WV 26301-5501
Pharmacy Comments
Contract Details
Approval Date
10/14/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Richard G Simon, CEO
(304) 924-6262
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/14/2019
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