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CENTERWELL PHARMACY, INC.
CH034050 BLUE RIDGE MEDICAL CENTER INC
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Covered Entity Details
Entity Name
BLUE RIDGE MEDICAL CENTER INC
Subdivision Name
BLUE RIDGE MEDICAL CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH034050
Entity Address
4038 Thomas Nelson Hwy
Arrington, VA 22922-2302
Grant Number
H80CS00175
Participating Start Date
12/1/1992
Last Recertification Date
2/17/2025
Pharmacy Details
Pharmacy Name
CENTERWELL PHARMACY, INC.
Pharmacy Address
11010 FLORIDA CROWN DRIVE, SUITE 200
ORLANDO, FL 32824
Pharmacy Comments
Contract Details
Approval Date
4/5/2024
Contract Begin Date
7/1/2024
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rodney S Johnson, CEO
(434) 263-4000
Contract Pharmacy Representative
Centerwell
Shelley Duke, Director, Pharmacy Market Development
(504) 705-6802 Ext: 5027056802
Signed By Date
4/5/2024
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