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NEW CUMBERLAND PRESCRIPTION
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
NEW CUMBERLAND PRESCRIPTION
Pharmacy Address
107 LINCOLN ST
NEW CUMBERLAND, WV 26047-9553
Pharmacy Comments
Contract Details
Approval Date
2/14/2013
Contract Begin Date
4/1/2013
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/1/2024
Pharmacy closed
Contacts
Covered Entity Signing Official
Judy Raveaux, CEO
(304) 797-7733 Ext: 1311
Contract Pharmacy Representative
New Cumberland RX
James Karnoupakis, President
(304) 387-2731
Signed By Date
1/11/2013
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