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PROCARE PHARMACY, L.L.C.
DSH510062 APPALACHIAN REGIONAL HEALTHCARE, INC.
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Covered Entity Details
Entity Name
APPALACHIAN REGIONAL HEALTHCARE, INC.
Subdivision Name
DBA BECKLEY ARH HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH510062
Entity Address
306 STANAFORD ROAD
BECKLEY, WV 25801
Medicare Provider Number
510062
Participating Start Date
4/1/2010
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
PROCARE PHARMACY, L.L.C.
Pharmacy Address
DBA CVS/PHARMACY #2923
3250 HARDEN ST. EXT. SUITE #300
COLUMBIA, SC 29203
Pharmacy Comments
Contract Details
Approval Date
4/9/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Joseph Grossman, PRESIDENT and CEO
(859) 226-2450
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/9/2021
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