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Walgreens #21423
CH030820 MONONGAHELA VALLEY ASN HLTH CTRS
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Covered Entity Details
Entity Name
MONONGAHELA VALLEY ASN HLTH CTRS
Subdivision Name
MVA Health Center - Fairmont
Type
HRSA-Funded Health Center
340B ID
CH030820
Entity Address
1322 LOCUST AVENUE
FAIRMONT, WV 26554
Grant Number
H80CS00383
Participating Start Date
10/1/1995
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
Walgreens #21423
Pharmacy Address
Walgreens Central Fill #21423
6275 Winchester Blvd
Canal WInchester, OH 43110-6537
Pharmacy Comments
Contract Details
Approval Date
1/5/2024
Contract Begin Date
4/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kevin Crockett, Acting CEO
(304) 367-8740
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
1/5/2024
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