340B Drug Pricing Program Database
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WALGREEN CO.
DSH510058 CAMDEN-CLARK MEMORIAL HOSP
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Covered Entity Details
Entity Name
CAMDEN-CLARK MEMORIAL HOSP
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510058
Entity Address
800 GARFIELD AVENUE
PARKERSBURG, WV 26101
Medicare Provider Number
510058
Participating Start Date
10/1/2015
Last Recertification Date
8/14/2024
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
WALGREENS #19614
2300 GRAND CENTRAL AVE
VIENNA, WV 26105-1347
Pharmacy Comments
Contract Details
Approval Date
10/18/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kyle Anthony Pierson, CFO
(304) 424-2202
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
10/18/2022
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