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CARILION CLINIC PHARMACY ROANOKE MEMORIA
CAH491304-00 CARILION ROCKBRIDGE COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
CARILION ROCKBRIDGE COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH491304-00
Entity Address
1 HEALTH CIRCLE
LEXINGTON, VA 24450
Medicare Provider Number
491304
Participating Start Date
8/30/2010
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
CARILION CLINIC PHARMACY ROANOKE MEMORIA
Pharmacy Address
1906 BELLEVIEW AVE SE
ROANOKE, VA 24014-1838
Pharmacy Comments
Contract Details
Approval Date
10/16/2019
Contract Begin Date
1/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Greg Todd Madsen, VP
(540) 458-3590
Contract Pharmacy Representative
Carilion Clinic
Chad Alvarez, Retail Pharmac Systems Director
(540) 510-4772
Signed By Date
10/16/2019
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