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WEST VIRGINIA CVS PHARMACY, L.L.C.
SCH490005-00 WINCHESTER MEDICAL CENTER
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Covered Entity Details
Entity Name
WINCHESTER MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH490005-00
Entity Address
1840 AMHERST STREET
WINCHESTER, VA 22601
Medicare Provider Number
490005
Participating Start Date
1/22/2021
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
WEST VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 04159
188 FLOWING SPRINGS RD.
CHARLES TOWN, WV 25414
Pharmacy Comments
Contract Details
Approval Date
1/15/2021
Contract Begin Date
4/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peter F. Gallagher, CFO
(540) 536-8031
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/15/2021
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