Contract Pharmacy Details

RITE AID OF WEST VIRGINIA, INC.
CH033130 E.A. HAWSE HEALTH CENTER, INC.

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

RITE AID OF WEST VIRGINIA, INC.

Pharmacy Address

RITE AID #3399
71 MOUNTAINEER DRIVE
HC 73 BOX 1-F
FRANKLIN, WV 26807

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

2/16/2018
Ownership change

Contacts

Covered Entity Signing Official

GARY T. JOHNSON, CEO
(304) 897-5915 Ext: 230

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

7/13/2017

340B Drug Pricing Program Database