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PHARMACY CARE OF HAMPTON ROADS AT PENINSULA INSTITUTE FOR COMMUNITY HEALTH
CH034100 PORTSMOUTH COMMUNITY HEALTH CENTER, INC.,d/b/a Hampton Roads Community Health Center
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Covered Entity Details
Entity Name
PORTSMOUTH COMMUNITY HEALTH CENTER, INC.,d/b/a Hampton Roads Community Health Center
Subdivision Name
PORTSMOUTH COMMUNITY HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
340B ID
CH034100
Entity Address
664 Lincoln St
Portsmouth, VA 23704-4818
Grant Number
H80CS00729
Participating Start Date
1/1/1994
Last Recertification Date
1/31/2023
Entity Termination Date
1/1/2024
Pharmacy Details
Pharmacy Name
PHARMACY CARE OF HAMPTON ROADS AT PENINSULA INSTITUTE FOR COMMUNITY HEALTH
Pharmacy Address
1033 28TH STREET
NEWPORT NEWS, VA 23607
Pharmacy Comments
Contract Details
Approval Date
12/28/2005
Contract Begin Date
12/28/2005
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
11/12/2015
Pharmacy closed
Contacts
Covered Entity Signing Official
Contract Pharmacy Representative
Signed By Date
12/28/2005
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