Contract Pharmacy Details

GIANT EAGLE SPECIALTY PHARMACY
DSH510001 WEST VIRGINIA UNIVERSITY HOSPITALS, INC.

Covered Entity Details

Entity Name

WEST VIRGINIA UNIVERSITY HOSPITALS, INC.

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH510001

Entity Address

1 MEDICAL CENTER DRIVE
MORGANTOWN, WV 26506

Medicare Provider Number

510001

Participating Start Date

7/1/2002

Last Recertification Date

8/15/2024

Pharmacy Details

Pharmacy Name

GIANT EAGLE SPECIALTY PHARMACY

Pharmacy Address

2500 LOVI RD
ROOM #101
FREEDOM, PA 15042

Pharmacy Comments

Contract Details

Approval Date

4/14/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Justin Gibson, VP of Finance-North Region
(304) 598-4256

Contract Pharmacy Representative

Giant Eagle, Inc.
Mike Bianco, Senior Pharmacy Manager
(412) 967-3718

Signed By Date

4/14/2025

340B Drug Pricing Program Database