Contract Pharmacy Details

CMC PHARMACY, LLC
DSH510055 Cabell Huntington Hospital, Inc.

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

CMC PHARMACY, LLC

Pharmacy Address

BIOMATRIX SPECIALTY PHARMACY WV
3100 MACCORKLE AVE SE STE 100
CHARLESTON, WV 25304-1215

Pharmacy Comments

Contract Details

Approval Date

10/10/2016

Contract Begin Date

1/1/2017

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/17/2023
Pharmacy closed

Contacts

Covered Entity Signing Official

David M. Ward, SENIOR VP AND CfO
(304) 526-2274

Contract Pharmacy Representative

Nicholas Karalis, President
(304) 344-8021

Signed By Date

10/10/2016

340B Drug Pricing Program Database