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TRI-STATE 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
TRI-STATE PHARMACY
Pharmacy Address
651 COLLIERS WAY STE 204
JOHN J. BERNABEI, RPH
WEIRTON, WV 26062-5055
Pharmacy Comments
Contract Details
Approval Date
10/2/2013
Contract Begin Date
1/1/2014
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
JUDY RAVEAUX, EXECUTIVE DIRECTOR
(304) 797-7733
Contract Pharmacy Representative
John Bernabei, Owner
(304) 723-6331
Signed By Date
10/2/2013
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