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HILL CITY PHARMACY INC DBA HILL CITY PHA
FQHCLA350A Community Access Network, Inc.
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Covered Entity Details
Entity Name
Community Access Network, Inc.
Subdivision Name
5th Street Community Health Center
Type
Health Center Program Look-Alike
340B ID
FQHCLA350A
Entity Address
800 5th Street, Suite A
Lynchburg, VA 24504-2430
Grant Number
LALCS31106
Participating Start Date
1/1/2018
Last Recertification Date
2/12/2025
Pharmacy Details
Pharmacy Name
HILL CITY PHARMACY INC DBA HILL CITY PHA
Pharmacy Address
819 VILLAGE HWY
RUSTBURG, VA 24588
Pharmacy Comments
Contract Details
Approval Date
1/5/2023
Contract Begin Date
4/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Christina Delzingaro, CEO
(434) 200-3366
Contract Pharmacy Representative
Hill City Pharmacy
Bryan Moody, Owner
(434) 237-2221
Signed By Date
1/5/2023
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