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WEST VIRGINIA CVS PHARMACY, L.L.C.
CH037460 VALLEY HEALTH CARE, INC
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Covered Entity Details
Entity Name
VALLEY HEALTH CARE, INC
Subdivision Name
VALLEY HEALTH CARE, INC.
Type
HRSA-Funded Health Center
340B ID
CH037460
Entity Address
46 Town Center PLZ STE A
MILL CREEK, WV 26280-9752
Grant Number
H80CS00583
Participating Start Date
9/9/2005
Last Recertification Date
2/26/2025
Pharmacy Details
Pharmacy Name
WEST VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03439
505 RANDOLPH AVE
ELKINS, WV 26241
Pharmacy Comments
Contract Details
Approval Date
10/15/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Jordan A. Godwin, CEO
(304) 335-2050 Ext: 101
Contract Pharmacy Representative
Valley Health Care
Jordan A. Godwin, CEO
(304) 335-2050 Ext: 101
Signed By Date
10/15/2019
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