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KROGER PHARMACY #734
DSH510062 APPALACHIAN REGIONAL HEALTHCARE, INC.
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Covered Entity Details
Entity Name
APPALACHIAN REGIONAL HEALTHCARE, INC.
Subdivision Name
DBA BECKLEY ARH HOSPITAL
Type
Disproportionate Share Hospital
340B ID
DSH510062
Entity Address
306 STANAFORD ROAD
BECKLEY, WV 25801
Medicare Provider Number
510062
Participating Start Date
4/1/2010
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
KROGER PHARMACY #734
Pharmacy Address
406 JOHN RAINE DRIVE
RAINELLE, WV 25962
Pharmacy Comments
04/30/2012 changed address (was 500 Park Center); 04/09/2012 state correction (was WI)
Contract Details
Approval Date
7/11/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Maria Braman, Chief Medical Officer
(406) 465-8506
Contract Pharmacy Representative
Kroger Health
Eva Brumfield, Strategic Program Director
(651) 357-2109
Signed By Date
7/11/2023
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