340B Drug Pricing Program Database

Pharmacy Name

PETERSTOWN PHARMACY, LLC

Pharmacy Address

ROBERT KELLEY MASSIE JF., RPH
125 MARKET STREET
P.O. BOX 338
PETERSTOWN, WV 24963

Pharmacy Comments

Approval Date

4/1/2004

Contract Begin Date

4/1/2004

Carve-In Effective Date

Contract Comments

6/27/13- reinstatement of contract pharmacy in relation to error in termination of the covered entity and subsequent reinstatement on3/11/13. Corrections previously made to the entities record for reinstatement failed to reinstate contract pharmacy- contract pharmacy has been eligible and no loss to its status should have occurred on 4/1/13- -this sites contract pharmacy has continued participation to date.

Contract Termination Date
Termination Reason

9/30/2020
Pharmacy closed

Covered Entity Signing Official


Contract Pharmacy Representative

Not available, Not available
(555) 555-5555

Signed By Date