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WEST VIRGINIA CVS PHARMACY, L.L.C.
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
WEST VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05961
30 HERITAGE CIRCLE
ROMNEY, WV 26757
Pharmacy Comments
Contract Details
Approval Date
7/13/2017
Contract Begin Date
10/1/2017
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/4/2018
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
GARY T. JOHNSON, CEO
(304) 897-5915 Ext: 230
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/13/2017
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