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WEST VIRGINIA CVS PHARMACY, L.L.C.
CAH511311-00 HAMPSHIRE MEMORIAL HOSPITAL, INC.
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Covered Entity Details
Entity Name
HAMPSHIRE MEMORIAL HOSPITAL, INC.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH511311-00
Entity Address
363 Sunrise Boulevard
ROMNEY, WV 26757
Medicare Provider Number
511311
Participating Start Date
9/13/2010
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
WEST VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01427
45 S. MINERAL ST.
KEYSER, WV 26726
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peter F. Gallagher, CFO
(540) 536-8031
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/13/2020
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