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CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
DSH510001 WEST VIRGINIA UNIVERSITY HOSPITALS, INC.
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Covered Entity Details
Entity Name
WEST VIRGINIA UNIVERSITY HOSPITALS, INC.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510001
Entity Address
1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506
Medicare Provider Number
510001
Participating Start Date
7/1/2002
Last Recertification Date
8/15/2024
Pharmacy Details
Pharmacy Name
CVS/SPECIALTY OR CARELONRX SPECIALTY PHA
Pharmacy Address
CAREMARK, LLC
1001 SPINKS ROAD, STE 280
FLOWER MOUND, TX 75028
Pharmacy Comments
Contract Details
Approval Date
1/13/2023
Contract Begin Date
4/1/2023
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
1/13/2023
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