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CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
CH033100 CAMDEN-ON-GAULEY MEDICAL CENTER, INC.
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Covered Entity Details
Entity Name
CAMDEN-ON-GAULEY MEDICAL CENTER, INC.
Subdivision Name
CAMDEN-ON-GAULEY MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH033100
Entity Address
10003 Webster Rd
Camden On Gauley, WV 26208
Grant Number
H80CS00078
Participating Start Date
12/1/1992
Last Recertification Date
2/23/2025
Pharmacy Details
Pharmacy Name
CVS CAREMARK ADVANCED TECHNOLOGY PHARMAC
Pharmacy Address
DBA CVS/CAREMARK 48067
1780 WALL ST
MT PROSPECT, IL 60056
Pharmacy Comments
Contract Details
Approval Date
10/16/2023
Contract Begin Date
1/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Margaret E Hickey, CEO
(304) 226-5725 Ext: 131
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/16/2023
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