Contract Pharmacy Details

MORGANTOWN DRUG COMPANY, LLC.
CH03421G Community Care of West Virginia, Inc.

Covered Entity Details

Entity Name

Community Care of West Virginia, Inc.

Subdivision Name

Community Care of Green Bank

Type

HRSA-Funded Health Center

340B ID

CH03421G

Entity Address

4498 Potomac Highlands Trl
Green Bank, WV 24944

Grant Number

H80CS00080

Participating Start Date

7/1/2012

Last Recertification Date

2/17/2025

Pharmacy Details

Pharmacy Name

MORGANTOWN DRUG COMPANY, LLC.

Pharmacy Address

DBA GREENBANK PHARMACY
P.O BOX 115, 4498 POTOMAC HIGHLANDS TRA
GREEN BANK, WV 24944

Pharmacy Comments

Contract Details

Approval Date

8/20/2012

Contract Begin Date

8/20/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

9/29/2022
Business decision by covered entity and/or pharmacy

Contacts

Covered Entity Signing Official

RICHARD G. SIMON, CEO
(304) 924-6262

Contract Pharmacy Representative

BatJac of South Carolina
TIM ROBBINS, PRESIDENT
(304) 364-5193

Signed By Date

7/24/2012

340B Drug Pricing Program Database