Contract Pharmacy Details

CARL WALKER'S DRUG STORE
CH034210 Community Care of West Virginia, Inc.

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

CARL WALKER'S DRUG STORE

Pharmacy Address

620 ELK ST
GASSAWAY, WV 26624

Pharmacy Comments

Contract Details

Approval Date

4/10/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/16/2020
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Richard G Simon, CEO
(304) 924-6262

Contract Pharmacy Representative

BatJac of South Carolina
TIM ROBBINS, PRESIDENT
(304) 364-5193

Signed By Date

4/10/2020

340B Drug Pricing Program Database