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HARNESS HEALTH PHARMACY
DSH490094 RICHMOND COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
RICHMOND COMMUNITY HOSPITAL
Subdivision Name
Type
Disproportionate Share Hospital
340B ID
DSH490094
Entity Address
1500 North 28TH Street
RICHMOND, VA 23223
Medicare Provider Number
490094
Participating Start Date
1/1/2004
Last Recertification Date
8/21/2024
Pharmacy Details
Pharmacy Name
HARNESS HEALTH PHARMACY
Pharmacy Address
7160 INDUSTRIAL ROW DR STE 331
MASON, OH 45040
Pharmacy Comments
Contract Details
Approval Date
1/14/2020
Contract Begin Date
4/1/2020
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/7/2024
Ownership change
Contacts
Covered Entity Signing Official
Stephan Quiriconi, Senior VP of Finance
(804) 281-8301
Contract Pharmacy Representative
Bon Secours Mercy Health
Behlan Ersoy, System Director Specialty Pharmacy
(513) 557-7661
Signed By Date
1/14/2020
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