340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
KROGER PHARMACY #722
DSH510030 DAVIS MEDICAL CENTER
Print
Covered Entity Details
Entity Name
DAVIS MEDICAL CENTER
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510030
Entity Address
812 Gorman Avenue
ELKINS, WV 26241
Medicare Provider Number
510030
Participating Start Date
1/1/2005
Last Recertification Date
8/22/2024
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #722
Pharmacy Address
80 SKYLINE PLAZA DR
BUCKHANNON, WV 26201
Pharmacy Comments
Contract Details
Approval Date
1/17/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
12/30/2024
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
William Lloyd Koch, Director of Financial Operations
(304) 637-3196
Contract Pharmacy Representative
Kroger Health
Eva Brumfield, Strategic Program Director
(651) 357-2109
Signed By Date
1/17/2023
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session