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KROGER PHARMACY #708
CH038800 WIRT COUNTY HEALTH SERVICE ASSOCIATION, INC
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Covered Entity Details
Entity Name
WIRT COUNTY HEALTH SERVICE ASSOCIATION, INC
Subdivision Name
Wirt County Family Care
Type
HRSA-Funded Health Center
340B ID
CH038800
Entity Address
483 COURT STREET
ELIZABETH, WV 26143-0609
Grant Number
H80CS00256
Participating Start Date
4/1/2004
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #708
Pharmacy Address
106 MCGRAW STREET
RIPLEY, WV 25271
Pharmacy Comments
Contract Details
Approval Date
2/27/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Dee Scritchfield, CEO
(304) 275-8780
Contract Pharmacy Representative
Kroger
Mike Puccini, New Business Development Manager
(513) 762-4672
Signed By Date
1/14/2013
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