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VIRGINIA CVS PHARMACY, L.L.C.
CAH491304-00 CARILION ROCKBRIDGE COMMUNITY HOSPITAL
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Covered Entity Details
Entity Name
CARILION ROCKBRIDGE COMMUNITY HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH491304-00
Entity Address
1 HEALTH CIRCLE
LEXINGTON, VA 24450
Medicare Provider Number
491304
Participating Start Date
8/30/2010
Last Recertification Date
9/5/2024
Pharmacy Details
Pharmacy Name
VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 07577
4126 PLANTATION ROAD
ROANOKE, VA 24012
Pharmacy Comments
Contract Details
Approval Date
10/15/2021
Contract Begin Date
1/1/2022
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Greg Todd Madsen, VP
(540) 458-3590
Contract Pharmacy Representative
CVS Health
Christian Reid, 340B Program Director
(401) 770-2118
Signed By Date
10/15/2021
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