Contract Pharmacy Details

WEST VIRGINIA CVS PHARMACY, L.L.C.
DSH510001 WEST VIRGINIA UNIVERSITY HOSPITALS, INC.

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

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

1/15/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/1/2020
Business decision by covered entity and/or pharmacy

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

340B Drug Pricing Program Database