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WEST VIRGINIA CVS PHARMACY, L.L.C.
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
WEST VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07124
3901 TEAYS VALLEY RD.
HURRICANE, WV 25526
Pharmacy Comments
Contract Details
Approval Date
4/10/2017
Contract Begin Date
7/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
David M. Ward, SENIOR VP AND CfO
(304) 526-2274
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/10/2017
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