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VALLEY PHARMACY & INFUSION
CAH491305-00 SHENANDOAH MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
SHENANDOAH MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH491305-00
Entity Address
759 SOUTH MAIN STREET
WOODSTOCK, VA 22664
Medicare Provider Number
491305
Participating Start Date
9/27/2010
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
VALLEY PHARMACY & INFUSION
Pharmacy Address
190 CAMPUS BLVD STE 110
WINCHESTER, VA 22601-2872
Pharmacy Comments
Contract Details
Approval Date
1/13/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Peter F. Gallagher, CFO
(540) 536-8031
Contract Pharmacy Representative
Valley Health System
Lori DeHaven, Director of Pharmacy
(540) 536-8899
Signed By Date
1/13/2020
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