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AMELIA PHARMACY
CH03418L SOUTHERN DOMINION HEALTH SYSTEMS, INC.
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Covered Entity Details
Entity Name
SOUTHERN DOMINION HEALTH SYSTEMS, INC.
Subdivision Name
AMELIA HEALTHCARE CENTER
Type
HRSA-Funded Health Center
340B ID
CH03418L
Entity Address
8920 Otterburn Rd
Amelia Court House, VA 23002-4854
Grant Number
H80CS00173
Participating Start Date
4/1/2005
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
AMELIA PHARMACY
Pharmacy Address
15412 PATRICK HENRY HWY
AMELIA COURT HOUSE, VA 23002
Pharmacy Comments
12/3/2010 - CONTRACT PHARMACY INFO MODIFIED TO CORRECT TYPOS.
Contract Details
Approval Date
12/2/2010
Contract Begin Date
12/2/2010
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
MARY R. TURNER, CEO
(434) 696-2165
Contract Pharmacy Representative
Farmville Family Pharmacy, Inc.
SCOTT GREGG, VP
(804) 379-6986
Signed By Date
11/10/2010
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