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T AND J ENTERPRISES INC
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
T AND J ENTERPRISES INC
Pharmacy Address
DBA THE MEDICINE SHOPPE
2402 ADAMS AVE
HUNTINGTON, WV 25704-1322
Pharmacy Comments
Contract Details
Approval Date
7/12/2013
Contract Begin Date
10/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/15/2023
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
David M. Ward, SENIOR VP AND CfO
(304) 526-2274
Contract Pharmacy Representative
JOE MCGLOTHIN, OWNER
Signed By Date
7/12/2013
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