Contract Pharmacy Details

WEST VIRGINIA CVS PHARMACY, L.L.C.
DSH510022 CHARLESTON AREA MEDICAL CENTER (CAMC)

Covered Entity Details

Entity Name

CHARLESTON AREA MEDICAL CENTER (CAMC)

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH510022

Entity Address

501 MORRIS STREET
CHARLESTON, WV 25301

Medicare Provider Number

510022

Participating Start Date

9/22/2005

Last Recertification Date

8/22/2024

Pharmacy Details

Pharmacy Name

WEST VIRGINIA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 04207
4205 MACCORKLE AVE.
CHARLESTON, WV 25304

Pharmacy Comments

Contract Details

Approval Date

10/14/2020

Contract Begin Date

1/1/2021

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

STEPHEN BELL, VICE PRESIDENT - FINANCE
(304) 388-6251

Contract Pharmacy Representative

CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782

Signed By Date

10/14/2020

340B Drug Pricing Program Database