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HARNESS HEALTH PHARMACY
CAH491308-00 RAPPAHANNOCK GENERAL HOSPITAL
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Covered Entity Details
Entity Name
RAPPAHANNOCK GENERAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH491308-00
Entity Address
101 HARRIS ROAD
KILMARNOCK, VA 22482-1449
Medicare Provider Number
491308
Participating Start Date
4/1/2017
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
HARNESS HEALTH PHARMACY
Pharmacy Address
7160 INDUSTRIAL ROW DR
SUITE 330
MASON, OH 45040
Pharmacy Comments
Contract Details
Approval Date
1/16/2019
Contract Begin Date
4/1/2019
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
6/15/2022
Business decision by covered entity and/or pharmacy
Contacts
Covered Entity Signing Official
Stephan Quiriconi, Senior VP of Finance
(804) 281-8301
Contract Pharmacy Representative
Mercy Health Pharmacy
Scott Spille, System Director - Retail Pharmacy
(859) 814-9786
Signed By Date
1/16/2019
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