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RIVER MEDICAL PHARMACY LLC
CAH511306-00 HOSPITAL DEVELOPMENT CORPORATION DBA ROANE GENERAL HOSPITAL
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Covered Entity Details
Entity Name
HOSPITAL DEVELOPMENT CORPORATION DBA ROANE GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH511306-00
Entity Address
200 HOSPITAL DRIVE
SPENCER, WV 25276
Medicare Provider Number
511306
Participating Start Date
7/1/2011
Last Recertification Date
9/3/2024
Pharmacy Details
Pharmacy Name
RIVER MEDICAL PHARMACY LLC
Pharmacy Address
4752 RESEARCH DR
SAN ANTONIO, TX 78240-5002
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
DOUGLAS E. BENTZ, CEO
(304) 927-6200
Contract Pharmacy Representative
BIOPLUS SPECIALTY PHARMACY
Bill Cook, Executive VP Sales and Business Development
(407) 388-5927 Ext: 4209
Signed By Date
1/15/2025
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