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FRUTH PHARMACY
CH05166D IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION
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Covered Entity Details
Entity Name
IRONTON AND LAWRENCE COUNTY AREA COMMUNITY ACTION ORGANIZATION
Subdivision Name
Ironton Health Care Campus
Type
HRSA-Funded Health Center
340B ID
CH05166D
Entity Address
1408 Campbell Dr
Ironton, OH 45638-2301
Grant Number
H80CS00471
Participating Start Date
4/1/2012
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
FRUTH PHARMACY
Pharmacy Address
FRUTH PHARMACY #11
425 CAMDEN RD
FRUTH PHARMACY
HUNTINGTON, WV 25704-2764
Pharmacy Comments
Contract Details
Approval Date
3/17/2017
Contract Begin Date
4/1/2017
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Kelly Adkins, Chief Financial Officer
(740) 532-3534 Ext: 12004
Contract Pharmacy Representative
Fruth Pharmacy
Tom Willoughby, Chief Financial Officer
(304) 675-1612 Ext: 163
Signed By Date
3/17/2017
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