340B Drug Pricing Program Database
Home
Search
Search Covered Entities
Search Contract Pharmacies
Search Manufacturers
Reports
Help
Login
GIANT PHARMACY #741
CHC12871-01 GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER, INC.
Print
Covered Entity Details
Entity Name
GREATER PRINCE WILLIAM COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Evergreen Terrace
Type
HRSA-Funded Health Center
340B ID
CHC12871-01
Entity Address
9705 Liberia Ave
Manassas, VA 20110-1743
Grant Number
H80CS12871
Participating Start Date
7/1/2014
Last Recertification Date
2/19/2025
Pharmacy Details
Pharmacy Name
GIANT PHARMACY #741
Pharmacy Address
5469 MAPLEDALE PLAZA
DALE CITY, VA 22193-4526
Pharmacy Comments
Contract Details
Approval Date
1/15/2025
Contract Begin Date
4/1/2025
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Mark Meye, Chief Executive Director
(703) 680-6524
Contract Pharmacy Representative
GIANT FOOD
KELLY SHANAHAN, DISTRICT PHARMACY MANAGER
(240) 461-2982
Signed By Date
1/15/2025
Continue Your Session
For security reasons inactive sessions are automatically closed.
Your session will be closed shortly if you don't continue it.
Continue Your Session