340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
FRUTH PHARMACY #25
DSH510029 Thomas Memorial Hospital
Print
Covered Entity Details
Entity Name
Thomas Memorial Hospital
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH510029
Entity Address
4605 MacCorkle Avenue, SW
South Charleston, WV 25309
Medicare Provider Number
510029
Participating Start Date
7/1/2014
Last Recertification Date
8/16/2024
Pharmacy Details
Pharmacy Name
FRUTH PHARMACY #25
Pharmacy Address
FRUTH EXPRESS
701 LEE STREET
CHARLESTON, WV 25301
Pharmacy Comments
Contract Details
Approval Date
4/15/2015
Contract Begin Date
7/1/2015
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/13/2025
Pharmacy closed
Contacts
Covered Entity Signing Official
Dan Lauffer, Chief Operating Officer
(304) 766-3595
Contract Pharmacy Representative
Fruth Pharmacy
Andy Becker, VP Pharmacy
(304) 675-1612 Ext: 10117
Signed By Date
4/15/2015
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session