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KROGER PHARMACY #754
CH038440 WOMENCARE, INC.
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Covered Entity Details
Entity Name
WOMENCARE, INC.
Subdivision Name
FamilyCare Health Center - Teays Valley
Type
HRSA-Funded Health Center
340B ID
CH038440
Entity Address
97 Great Teays Blvd STE 6
Scott Depot, WV 25560-9816
Grant Number
H80CS00827
Participating Start Date
7/1/2000
Last Recertification Date
2/18/2025
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #754
Pharmacy Address
10635 MACCORKLE AVE. S.E.
MARMET, WV 25315
Pharmacy Comments
Contract Details
Approval Date
1/24/2022
Contract Begin Date
4/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Craig Glover, President/CEO
(304) 760-6316
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
1/24/2022
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