Contract Pharmacy Details

RITE AID OF VIRGINIA, INC.
CH034180 SOUTHERN DOMINION HEALTH SYSTEMS, INC.

Covered Entity Details

Entity Name

SOUTHERN DOMINION HEALTH SYSTEMS, INC.

Subdivision Name

ADMINISTRATIVE OFFICE

Type

HRSA-Funded Health Center

340B ID

CH034180

Entity Address

1508 K-V ROAD
VICTORIA, VA 23974

Grant Number

H80CS00173

Participating Start Date

12/1/1992

Last Recertification Date

2/10/2025

Pharmacy Details

Pharmacy Name

RITE AID OF VIRGINIA, INC.

Pharmacy Address

RITE AID #2488
15105 PATRICK HENRY HWY
AMELIA COURT HOUSE, VA 23002

Pharmacy Comments

Contract Details

Approval Date

10/15/2012

Contract Begin Date

10/15/2012

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/29/2017
Ownership change

Contacts

Covered Entity Signing Official

Jill Seamans, CFO
(434) 696-2165

Contract Pharmacy Representative

Rite Aid
Ruth Lightner, Director
(717) 731-6524

Signed By Date

9/11/2012

340B Drug Pricing Program Database