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JUDY'S DRUG STORE INC
CH033130 E.A. HAWSE HEALTH CENTER, INC.
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Covered Entity Details
Entity Name
E.A. HAWSE HEALTH CENTER, INC.
Subdivision Name
Central Office
Type
HRSA-Funded Health Center
340B ID
CH033130
Entity Address
17978 STATE ROUTE 55
BAKER, WV 26801-0097
Grant Number
H80CS00563
Participating Start Date
10/1/2004
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
JUDY'S DRUG STORE INC
Pharmacy Address
24 N MAIN ST
PETERSBURG, WV 26847-1518
Pharmacy Comments
Contract Details
Approval Date
7/8/2010
Contract Begin Date
7/8/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
GARY T. JOHNSON, CEO
(304) 897-5915 Ext: 230
Contract Pharmacy Representative
STEVEN C. JUDY, OWNER
(304) 530-1044
Signed By Date
7/7/2010
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