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TIMBERLAKE HEALTH AND WELLNESS
CH0310560 JOHNSON HEALTH CENTER
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Covered Entity Details
Entity Name
JOHNSON HEALTH CENTER
Subdivision Name
JOHNSON HEALTH CENTER
Type
HRSA-Funded Health Center
340B ID
CH0310560
Entity Address
320 Federal St
Lynchburg, VA 24504-2306
Grant Number
H80CS02445
Participating Start Date
10/1/2004
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
TIMBERLAKE HEALTH AND WELLNESS
Pharmacy Address
22776 TIMBERLAKE RD
SUITE D
LYNCHBURG, VA 24502
Pharmacy Comments
Contract Details
Approval Date
7/2/2018
Contract Begin Date
10/1/2018
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Gary Campbell, CEO
(434) 455-2480 Ext: 1102
Contract Pharmacy Representative
Rustburg Pharmacy
Vince Ettare, Owner
(434) 332-1730
Signed By Date
7/2/2018
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