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WALGREEN CO.
SCH490021-00 CENTRA HEALTH, INC
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Covered Entity Details
Entity Name
CENTRA HEALTH, INC
Subdivision Name
Lynchburg General Hospital
Type
Sole Community Hospital
340B ID
SCH490021-00
Entity Address
1901 TATE SPRINGS RD
LYNCHBURG, VA 24501
Medicare Provider Number
490021
Participating Start Date
4/1/2011
Last Recertification Date
8/31/2022
Entity Termination Date
10/1/2023
Pharmacy Details
Pharmacy Name
WALGREEN CO.
Pharmacy Address
DBA: WALGREENS #10691
5006 BOONSBORO RD.
LYNCHBURG, VA 24503
Pharmacy Comments
Contract Details
Approval Date
4/19/2022
Contract Begin Date
7/1/2022
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
10/1/2023
Covered Entity Terminated
Contacts
Covered Entity Signing Official
Georgia Harrington, Chief Operating Officer
(434) 200-5794
Contract Pharmacy Representative
Walgreens
Karl Meehan, Vice President, Health Systems Programs
(847) 315-2663
Signed By Date
4/19/2022
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