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HARRIS TEETER #133
CH031060A NEIGHBORHOOD HEALTH
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Covered Entity Details
Entity Name
NEIGHBORHOOD HEALTH
Subdivision Name
2 EAST GLEBE RD
Type
HRSA-Funded Health Center
340B ID
CH031060A
Entity Address
2 E GLEBE RD
Alexandria, VA 22305
Grant Number
H80CS02446
Participating Start Date
1/1/2007
Last Recertification Date
2/16/2025
Pharmacy Details
Pharmacy Name
HARRIS TEETER #133
Pharmacy Address
4641 DUKE ST
ALEXANDRIA, VA 22304
Pharmacy Comments
Contract Details
Approval Date
10/8/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Basim Khan, Executive Director
(703) 535-5568 Ext: 4104
Contract Pharmacy Representative
Kroger
Anastasia Frey, Senior Manager, Payor Contracting
(513) 698-1875
Signed By Date
10/8/2019
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