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VIRGINIA CVS PHARMACY, L.L.C.
CAH491305-00 SHENANDOAH MEMORIAL HOSPITAL
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Covered Entity Details
Entity Name
SHENANDOAH MEMORIAL HOSPITAL
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH491305-00
Entity Address
759 SOUTH MAIN STREET
WOODSTOCK, VA 22664
Medicare Provider Number
491305
Participating Start Date
9/27/2010
Last Recertification Date
8/23/2024
Pharmacy Details
Pharmacy Name
VIRGINIA CVS PHARMACY, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 01552
780 MARTIN LUTHER KING JR. WAY
HARRISONBURG, VA 22801
Pharmacy Comments
Contract Details
Approval Date
7/17/2023
Contract Begin Date
10/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Robert Amos, CFO, Valley Health System
(540) 536-8031
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
7/17/2023
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