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WEST VIRGINIA CVS PHARMACY, L.L.C.
CAH491300-00 Bath County Community Hospital, Inc.
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Covered Entity Details
Entity Name
Bath County Community Hospital, Inc.
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH491300-00
Entity Address
106 Park Drive
Hot Springs, VA 24445
Medicare Provider Number
491300
Participating Start Date
1/1/2014
Last Recertification Date
8/19/2024
Pharmacy Details
Pharmacy Name
WEST VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 06333
9781 SENECA TRAIL S.
LEWISBURG, WV 24901
Pharmacy Comments
Contract Details
Approval Date
4/15/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Tom Vandenhoven, CFO
(540) 839-7138
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/15/2022
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