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CRAB ORCHARD PHARMACY, INC.
DSH510062 APPALACHIAN REGIONAL HEALTHCARE, INC.
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Covered Entity Details
Entity Name
APPALACHIAN REGIONAL HEALTHCARE, INC.
Subdivision Name
DBA BECKLEY ARH HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH510062
Entity Address
306 STANAFORD ROAD
BECKLEY, WV 25801
Medicare Provider Number
510062
Participating Start Date
4/1/2010
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
CRAB ORCHARD PHARMACY, INC.
Pharmacy Address
1299 ROBERT C BYRD DR
PO BOX 276
CRAB ORCHARD, WV 25827
Pharmacy Comments
Contract Details
Approval Date
7/7/2020
Contract Begin Date
10/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Contract Pharmacy Representative
Crab Orchard Pharmacy
Richard Sallaz, Owner
(304) 253-7474
Signed By Date
7/7/2020
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