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WEST VIRGINIA CVS PHARMACY, L.L.C.
RRC510050-00 WHEELING HOSPITAL
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Covered Entity Details
Entity Name
WHEELING HOSPITAL
Subdivision Name
Type
Rural Referral Center
340B ID
RRC510050-00
Entity Address
1 MEDICAL PARK
WHEELING, WV 26003
Medicare Provider Number
510050
Participating Start Date
4/1/2022
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
WEST VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03017
1126-28 MARKET ST
WHEELING, WV 26003
Pharmacy Comments
Contract Details
Approval Date
1/25/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/1/2022
Pharmacy closed
Contacts
Covered Entity Signing Official
James Brian Murdy, Chief Administrative Officer
(304) 243-3681
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
1/17/2022
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