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TRI-COUNTY PHARMACY
CH03421F Community Care of West Virginia, Inc.
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Covered Entity Details
Entity Name
Community Care of West Virginia, Inc.
Subdivision Name
Community Care of Marlinton
Type
HRSA-Funded Health Center
340B ID
CH03421F
Entity Address
821 3rd Ave
Marlinton, WV 24954-1015
Grant Number
H80CS00080
Participating Start Date
7/1/2010
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
TRI-COUNTY PHARMACY
Pharmacy Address
COMMNITY CARE OF WEST VIRGINIA
123 QUEENS ALLEY RD
PO BOX 217
ROCK CAVE, WV 26234
Pharmacy Comments
Contract Details
Approval Date
9/1/2010
Contract Begin Date
9/1/2010
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
9/30/2020
Agreement registered in error
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
8/11/2010
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