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FRUTH PHARMACY
CH034120 ROANE FAMILY HEALTH CARE
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Covered Entity Details
Entity Name
ROANE FAMILY HEALTH CARE
Subdivision Name
ROANE COUNTY FAMILY HEALTH CARE
Type
HRSA-Funded Health Center
340B ID
CH034120
Entity Address
146 Williams Dr
Spencer, WV 25276-1826
Grant Number
H80CS00388
Participating Start Date
7/1/2004
Last Recertification Date
2/14/2025
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
Contacts
Covered Entity Signing Official
Kip Smith, CEO
(304) 927-2241 Ext: 170
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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