Contract Pharmacy Details

RITE AID OF VIRGINIA, INC.
CH033130 E.A. HAWSE HEALTH CENTER, INC.

Covered Entity Details

Entity Name

E.A. HAWSE HEALTH CENTER, INC.

Subdivision Name

Central Office

Type

HRSA-Funded Health Center

340B ID

CH033130

Entity Address

17978 STATE ROUTE 55
BAKER, WV 26801-0097

Grant Number

H80CS00563

Participating Start Date

10/1/2004

Last Recertification Date

2/11/2025

Pharmacy Details

Pharmacy Name

RITE AID OF VIRGINIA, INC.

Pharmacy Address

RITE AID #1851
14111 TIMBER WAY
TIMBERVILLE, VA 22853

Pharmacy Comments

Contract Details

Approval Date

10/9/2015

Contract Begin Date

1/1/2016

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

12/13/2017
Ownership change

Contacts

Covered Entity Signing Official

GARY T. JOHNSON, CEO
(304) 897-5915 Ext: 230

Contract Pharmacy Representative

Rite Aid
Alison Farrell, Vice President |Managed Care
(717) 975-5968

Signed By Date

10/9/2015

340B Drug Pricing Program Database