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PROCARE PHARMACY DIRECT, L.L.C.
DSH510001 WEST VIRGINIA UNIVERSITY HOSPITALS, INC.
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Covered Entity Details
Entity Name
WEST VIRGINIA UNIVERSITY HOSPITALS, INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510001
Entity Address
1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506
Medicare Provider Number
510001
Participating Start Date
7/1/2002
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY DIRECT, L.L.C.
Pharmacy Address
DBA CVS/SPECIALTY OR CARELONRX SPECIALTY
105 MALL BOULEVARD
MONROEVILLE, PA 15146
Pharmacy Comments
12/11/2009 - PHARMACY MOVED FROM 600 PENN CENTER BLVD., PITTSBURGH, PA 15235-5810 AND NAME CHANGE (WAS PROCARE PHARMACY DIRECT, INC DBA PHARMACARE SPECIALTY PHARMACY)
Contract Details
Approval Date
1/15/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Melissa D McCoy, Chief Financial Officer
(304) 598-4554
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2020
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