Contract Pharmacy Details

POTOMAC HIGHLANDS PHARMACY
CH033130 E.A. HAWSE HEALTH CENTER, INC.

Covered Entity Details

Entity Name

E.A. HAWSE HEALTH CENTER, INC.

Subdivision Name

Central Office

Type

HRSA-Funded Health Center

340B ID

CH033130

Entity Address

17978 STATE ROUTE 55
BAKER, WV 26801-0097

Grant Number

H80CS00563

Participating Start Date

10/1/2004

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

POTOMAC HIGHLANDS PHARMACY

Pharmacy Address

DIVISION OF E.A. HAWSE HEALTH CENTER, IN
22347 NORTHWESTERN PIKE
ROMNEY, WV 26757

Pharmacy Comments

Contract Details

Approval Date

10/11/2023

Contract Begin Date

1/1/2024

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

4/22/2025
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

Melissa Walls, CEO
(304) 897-5915 Ext: 230

Contract Pharmacy Representative

E.A. Hawse Health Center, Inc.
Charles Rohrbaugh, Chief Operations Officer
(304) 897-5915 Ext: 264

Signed By Date

10/11/2023

340B Drug Pricing Program Database