340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
MARYLAND CVS PHARMACY, L.L.C.
CAH511315-00 POTOMAC VALLEY HOSPITAL
Print
Covered Entity Details
Entity Name
POTOMAC VALLEY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH511315-00
Entity Address
100 PIN OAK LANE
KEYSER, WV 26726
Medicare Provider Number
511315
Participating Start Date
4/1/2016
Last Recertification Date
8/12/2024
Pharmacy Details
Pharmacy Name
MARYLAND CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05728
1202 NATIONAL HWY
LA VALE, MD 21502
Pharmacy Comments
Contract Details
Approval Date
1/17/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Justin Gibson, VP of Finance-North Region
(304) 598-4256
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/17/2022
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session