Contract Pharmacy Details

VIRGINIA CVS PHARMACY, L.L.C.
CH030720 EASTERN SHORE RURAL HEALTH SYSTEM, INC

Covered Entity Details

Entity Name

EASTERN SHORE RURAL HEALTH SYSTEM, INC

Subdivision Name

Eastern Shore Rural Health System, Inc.

Type

HRSA-Funded Health Center

340B ID

CH030720

Entity Address

20280 Market St
Onancock, VA 23417

Grant Number

H80CS00791

Participating Start Date

10/1/1999

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

VIRGINIA CVS PHARMACY, L.L.C.

Pharmacy Address

DBA: CVS/PHARMACY # 01570
25201 LANKFORD HWY.
ONLEY, VA 23418

Pharmacy Comments

Contract Details

Approval Date

1/15/2020

Contract Begin Date

4/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

NANCY J. STERN, CEO
(757) 414-0400 Ext: 117

Contract Pharmacy Representative

Eastern Shore Rural Health System, Inc.
KIMBERLY Bloxom SAVAGE, CHIEF COMPLIANCE OFFICER
(757) 414-0400 Ext: 108

Signed By Date

1/15/2020

340B Drug Pricing Program Database