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MOUNTAINEER DRUG INC.
CH031250 BLUESTONE HEALTH ASSOCIATION, INC.
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Covered Entity Details
Entity Name
BLUESTONE HEALTH ASSOCIATION, INC.
Subdivision Name
BLUESTONE HEALTH ASSOCIATION, INC.
Type
HRSA-Funded Health Center
340B ID
CH031250
Entity Address
3997 Beckley Rd
Princeton, WV 24740-7660
Grant Number
H80CS00450
Participating Start Date
7/1/1998
Last Recertification Date
2/11/2025
Pharmacy Details
Pharmacy Name
MOUNTAINEER DRUG INC.
Pharmacy Address
76 LEWIS STREET
WHITESVILLE, WV 25209
Pharmacy Comments
Contract Details
Approval Date
4/16/2018
Contract Begin Date
7/1/2018
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/20/2019
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Linda Hutchens, CEO
(304) 431-5499 Ext: 1168
Contract Pharmacy Representative
Mountaineer Drug
Aaron Smarr, Owner
(304) 380-8769
Signed By Date
4/16/2018
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