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RIVERSIDE PHARMACY INC
CHC26637-00 WILLIAMSON HEALTH AND WELLNESS CENTER
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Covered Entity Details
Entity Name
WILLIAMSON HEALTH AND WELLNESS CENTER
Subdivision Name
Williamson Health and Wellness Center
Type
HRSA-Funded Health Center
340B ID
CHC26637-00
Entity Address
184 E. 2nd Avenue, Suite 210
Williamson, WV 25661-3602
Grant Number
H80CS26637
Participating Start Date
1/1/2017
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
RIVERSIDE PHARMACY INC
Pharmacy Address
RIVERSIDE PHARMACY INC
22 LARRY JOE HARLESS DRIVE
GILBERT, WV 25621
Pharmacy Comments
Contract Details
Approval Date
4/14/2020
Contract Begin Date
7/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christopher Beckett, CEO
(304) 235-3400
Contract Pharmacy Representative
Riverside Pharmacy
Cameron Hatfield, N/A
(304) 682-8132
Signed By Date
4/14/2020
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