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FRUTH PHARMACY
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
FRUTH PHARMACY
Pharmacy Address
FRUTH PHARMACY #11
425 CAMDEN RD
FRUTH PHARMACY
HUNTINGTON, WV 25704-2764
Pharmacy Comments
Contract Details
Approval Date
10/2/2014
Contract Begin Date
1/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/16/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Julie Stanley, CFO
(304) 275-8780
Contract Pharmacy Representative
Fruth Pharmacy
Tom Willoughby, Chief Financial Officer
(304) 675-1612 Ext: 163
Signed By Date
10/2/2014
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