Contract Pharmacy Details

WALGREEN CO.
CH030700 CENTRAL VIRGINIA HEALTH SERVICES, INC.

Covered Entity Details

Entity Name

CENTRAL VIRGINIA HEALTH SERVICES, INC.

Subdivision Name

CVHS Buckingham

Type

HRSA-Funded Health Center

340B ID

CH030700

Entity Address

25892 N James Madison Hwy
New Canton, VA 23123-2234

Grant Number

H80CS00479

Participating Start Date

7/1/1995

Last Recertification Date

2/28/2025

Pharmacy Details

Pharmacy Name

WALGREEN CO.

Pharmacy Address

WALGREENS #18211
11129 GORDON RD
FREDERICKSBURG, VA 22407-1714

Pharmacy Comments

Contract Details

Approval Date

7/17/2018

Contract Begin Date

10/1/2018

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

3/20/2025
Pharmacy closed

Contacts

Covered Entity Signing Official

Paula A. Tomko, Chief Executive Officer
(434) 581-3276

Contract Pharmacy Representative

Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663

Signed By Date

7/17/2018

340B Drug Pricing Program Database