Contract Pharmacy Details

VCU HEALTH SYSTEM PHARMACY
RWIID94 VIRGINIA DEPARTMENT OF HEALTH

Covered Entity Details

Entity Name

VIRGINIA DEPARTMENT OF HEALTH

Subdivision Name

DIVISION OF DISEASE PREVENTION - ADAP Direct Purchase

Type

Ryan White Part B ADAP Direct Purchase

340B ID

RWIID94

Entity Address

109 Governor Street
Richmond, VA 23219

Grant Number

X07HA00009

Participating Start Date

12/1/1992

Last Recertification Date

3/5/2025

Pharmacy Details

Pharmacy Name

VCU HEALTH SYSTEM PHARMACY

Pharmacy Address

1250 E MARSHALL ST
MAIN HOSPITAL
RICHMOND, VA 23298-5051

Pharmacy Comments

10/5/10 UPDATED PHARMACY NAME (WAS VA HEALTH SYSTEM PHARMACY);

Contract Details

Approval Date

4/14/2020

Contract Begin Date

7/1/2020

Carve-In Effective Date

Contract Comments

Contacts

Covered Entity Signing Official

Lilian R. Peake, Director Office of Epidemiology
(804) 864-8207

Contract Pharmacy Representative

Ambulatory Care Clinic Pharmacy -VCUHS Pharmacy
Ronald Lefever, Lead Pharmacist
(804) 828-0355

Signed By Date

4/14/2020

340B Drug Pricing Program Database