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VIRGINIA CVS PHARMACY, L.L.C.
SCH490018-00 AUGUSTA MEDICAL CENTER
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Covered Entity Details
Entity Name
AUGUSTA MEDICAL CENTER
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH490018-00
Entity Address
78 MEDICAL CENTER DRIVE
FISHERSVILLE, VA 22939
Medicare Provider Number
490018
Participating Start Date
7/1/2020
Last Recertification Date
9/9/2024
Pharmacy Details
Pharmacy Name
VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01557
1302 BARTERBROOK RD.
STAUNTON, VA 24401
Pharmacy Comments
Contract Details
Approval Date
4/14/2021
Contract Begin Date
7/1/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Karen C Clark, Vice President of Operations
(540) 332-4800
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
4/14/2021
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