Contract Pharmacy Details

HOMETOWN PHARMACY
CH0310560 JOHNSON HEALTH CENTER

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

HOMETOWN PHARMACY

Pharmacy Address

196 AMELON SQ
MADISON HEIGHTS, VA 24572-5990

Pharmacy Comments

Contract Details

Approval Date

4/3/2019

Contract Begin Date

7/1/2019

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Gary Campbell, CEO
(434) 455-2480 Ext: 1102

Contract Pharmacy Representative

HOMETOWN PHARMACY
Lisa Smith, Owner
(434) 929-1000

Signed By Date

4/3/2019