Contract Pharmacy Details

WALGREEN CO.
CH034210 Community Care of West Virginia, Inc.

Covered Entity Details

Entity Name

Community Care of West Virginia, Inc.

Subdivision Name

Community Care of Rock Cave

Type

HRSA-Funded Health Center

340B ID

CH034210

Entity Address

78 Queens Alley Rd
ROCK CAVE, WV 26234-0217

Grant Number

H80CS00080

Participating Start Date

4/1/2003

Last Recertification Date

2/17/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

DBA: WALGREENS #12276
1240 W. MAIN ST.
BRIDGEPORT, WV 26330

Pharmacy Comments

Contract Details

Approval Date

4/15/2025

Contract Begin Date

7/1/2025

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Patricia Collett, Chief Executive Officer
(304) 473-5560

Contract Pharmacy Representative

Walgreens
Ruthann Archer, Director of 340B Operations
(847) 964-8116

Signed By Date

4/15/2025

340B Drug Pricing Program Database