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WEST VIRGINIA CVS PHARMACY, L.L.C.
CH03082C MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC
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Covered Entity Details
Entity Name
MONONGAHELA VALLEY ASSOCIATION OF HEALTH CENTERS, INC
Subdivision Name
MVA Health Center - North Marion High School Wellness Center
Type
HRSA-Funded Health Center
340B ID
CH03082C
Entity Address
1 N Marion Dr
Farmington, WV 26571-9717
Grant Number
H80CS00383
Participating Start Date
4/1/2017
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
WEST VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 05955
2 RAINBOW PLAZA
MANNINGTON, WV 26582
Pharmacy Comments
Contract Details
Approval Date
1/16/2024
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
CVS
McKenzie Heffernan, Senior Account Manager
(518) 226-2975
Signed By Date
1/16/2024
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