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KROGER PHARMACY
CH037920 RITCHIE COUNTY PRIMARY CARE ASSOCIATION, INC
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Covered Entity Details
Entity Name
RITCHIE COUNTY PRIMARY CARE ASSOCIATION, INC
Subdivision Name
Type
HRSA-Funded Health Center
340B ID
CH037920
Entity Address
135 SOUTH PENN AVE
HARRISVILLE, WV 26362
Grant Number
H80CS00843
Participating Start Date
1/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY
Pharmacy Address
2007 E 7TH ST
PARKERSBURG, WV 26101
Pharmacy Comments
Contract Details
Approval Date
1/12/2015
Contract Begin Date
4/1/2015
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
WILLIAM H. SNIDER II, CEO
(304) 643-4005
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
1/12/2015
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