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FOLLANSBEE PHARMACY
CHC08238-00 CHANGE, INCORPORATED
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Covered Entity Details
Entity Name
CHANGE, INCORPORATED
Subdivision Name
Family Medical Care Community Health Center - Hancock County
Type
HRSA-Funded Health Center
340B ID
CHC08238-00
Entity Address
3136 West St
Weirton, WV 26062-4637
Grant Number
H80CS08238
Participating Start Date
4/1/2007
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
FOLLANSBEE PHARMACY
Pharmacy Address
1415 MAIN ST
FOLLANSBEE, WV 26037-1217
Pharmacy Comments
Contract Details
Approval Date
6/11/2012
Contract Begin Date
6/22/2012
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Judy Raveaux, CEO
(304) 797-7733 Ext: 1311
Contract Pharmacy Representative
John Bernabei, Owner
(304) 723-6331
Signed By Date
6/15/2012
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