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FRUTH PHARMACY
DSH510055 Cabell Huntington Hospital, Inc.
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Covered Entity Details
Entity Name
Cabell Huntington Hospital, Inc.
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510055
Entity Address
1340 Hal Greer Blvd.
Huntington, WV 25701-0195
Medicare Provider Number
510055
Participating Start Date
4/1/2005
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
FRUTH PHARMACY
Pharmacy Address
FRUTH PHARMACY #8
259 STATE STREET
PROCTORVILLE, OH 45669
Pharmacy Comments
Contract Details
Approval Date
7/17/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David M. Ward, SENIOR VP AND CfO
(304) 526-2274
Contract Pharmacy Representative
Craig Kimble, Corporate Director of Pharmacy
(304) 675-1612 Ext: 120
Signed By Date
7/17/2013
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