340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
AMAZON PHARMACY #010
CH033080 RAINELLE MEDICAL CENTER
Print
Covered Entity Details
Entity Name
RAINELLE MEDICAL CENTER
Subdivision Name
RAINELLE MEDICAL CENTER
Type
HRSA-Funded Health Center
340B ID
CH033080
Entity Address
176 Medical Center Drive
Rainelle, WV 25962-1013
Grant Number
H80CS18278
Participating Start Date
4/1/1996
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
AMAZON PHARMACY #010
Pharmacy Address
1331 E 6TH ST
CORONA, CA 92879
Pharmacy Comments
Contract Details
Approval Date
7/16/2024
Contract Begin Date
10/1/2024
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
3/31/2025
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
KRISTI ATHA-RADER, CEO
(304) 438-6188 Ext: 1006
Contract Pharmacy Representative
AMAZON PHARMACY
JOHN M LAVIN, MANAGING OFFICER
(602) 793-8552
Signed By Date
7/16/2024
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session