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SHAWSVILLE PHARMACY INC
CHC26516-02 Free Clinic Of The New River Valley Inc
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Covered Entity Details
Entity Name
Free Clinic Of The New River Valley Inc
Subdivision Name
Pulaski/Radford Clinic
Type
HRSA-Funded Health Center
340B ID
CHC26516-02
Entity Address
5826 RUEBUSH RD STE B
Dublin, VA 24084-2252
Grant Number
H80CS26516
Participating Start Date
10/1/2019
Last Recertification Date
2/10/2025
Pharmacy Details
Pharmacy Name
SHAWSVILLE PHARMACY INC
Pharmacy Address
250 ALLEGHANY SPRING RD
SHAWSVILLE, VA 24162
Pharmacy Comments
Contract Details
Approval Date
10/7/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Matthew Pitonyak, Chief Financial Officer
(540) 232-9960
Contract Pharmacy Representative
Shawsville Pharmcay
Senthil Marimuthu, Owner
(540) 232-9960
Signed By Date
10/7/2021
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